Artikel
Predictors of surgical outcome in degenerative disc disease: Evaluation of physical, mental and social factors
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Autoren
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Jeff Thiel
- Neurochirurgische Klinik, Technische Universität München, Germany
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Youssef Shiban
- Klinische Psychologie und Psychotherapie, Universität Klinikum Regensburg, Germany
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Jens Lehmberg
- Neurochirurgische Klinik, Technische Universität München, Germany
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Bernhard Meyer
- Neurochirurgische Klinik, Technische Universität München, Germany
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Ehab Shiban
- Neurochirurgische Klinik, Technische Universität München, Germany
| Veröffentlicht: | 8. Juni 2016 |
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Gliederung
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Objective: The influence of psychological and social factors has only recently been acknowledged to impact clinical outcome following spine surgery. Some studies demonstrated that preoperative affective disorders are predictors of poor outcome after spinal surgery. We aimed to identify potential risk factors for unfavourable outcome following spine surgery for degenerative disc disease.
Method: In a prospective observational study the authors determined quantitative measurements of pain (visual analog scale [VAS]), quality of life (36-Item Short Form Health Survey [SF-36]), disease-specific disability (Oswestry Disability Index [ODI]), metal status (anxiety [ASI-3] and Depression [ASD-K]) and Social status (Berliner Social Support Scale [BSSS], education level). Uni- and multivariate analyses were performed to assess associations between the various preoperative factors with achievement of a minimum clinical important difference (MCID) in ODI by 12 months postoperatively.
Results: 113 patients met all inclusion criteria. 64 patients were male (56.6%); mean age was 60.1 years. Most patients were married or in a permanent relationship (77.0%). 55.7 % of patients achieved a minimally clinical important difference of ≥15 in the ODI score. Preoperatively age (r=0.215; p=0.001), pain (VAS) (r=0.356; p<0.001), trait anxiety (r=0.198; p=0.039), ODI (r=0.599; p<0.001), depression score ADS-K (r=0.319; p=0.01), lower education (r=-0.206; p=0.05) and lower SF-36 PCS (r=-0.542; p<0.001) correlated with worse ODI scores at 1 year. A stepwise logistic regression model showed significant association with age and SF-36 PCS score (p=0.014).
Conclusions: Clinical outcome one year after surgery is strongly influenced by pre-operative age and physical status. Mental comorbidities and social status are also influential on clinical outcome.
Note: Jeff Thiel and Youssef Shiban contributed equally.
