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67. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC)
Joint Meeting mit der Koreanischen Gesellschaft für Neurochirurgie (KNS)

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

12. - 15. Juni 2016, Frankfurt am Main

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Incidence and influence of depression and anxiety on clinical outcome before and one year after spine surgery for degenerative disc disease

Meeting Abstract

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  • Ehab Shiban - Neurochirurgische Klinik, Technische Universität München, Germany
  • Youssef Shiban - Klinische Psychologie und Psychotherapie, Universitätsklinikum Regensburg, Germany
  • Jeff Thiel - Neurochirurgische Klinik, Technische Universität München, Germany
  • Jens Lehmberg - Neurochirurgische Klinik, Technische Universität München, Germany
  • Bernhard Meyer - Neurochirurgische Klinik, Technische Universität München, Germany

Deutsche Gesellschaft für Neurochirurgie. 67. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), 1. Joint Meeting mit der Koreanischen Gesellschaft für Neurochirurgie (KNS). Frankfurt am Main, 12.-15.06.2016. Düsseldorf: German Medical Science GMS Publishing House; 2016. DocMI.19.04

doi: 10.3205/16dgnc352, urn:nbn:de:0183-16dgnc3526

Veröffentlicht: 8. Juni 2016

© 2016 Shiban et al.
Dieser Artikel ist ein Open-Access-Artikel und steht unter den Lizenzbedingungen der Creative Commons Attribution 4.0 License (Namensnennung). Lizenz-Angaben siehe http://creativecommons.org/licenses/by/4.0/.

Gliederung

Text

Objective: It is widely accepted that psychiatric comorbidities have a negative influence on clinical outcome following spine surgery for degenerative disc disease. However, most published data is restricted to postoperative measurements and data from preoperative settings is lacking. Aim of this study was to assess the incidence and influence of psychiatric comorbidities on clinical outcome in patients undergoing elective spine surgery.

Method: A prospective study of patients undergoing elective spine surgery was performed. Evaluations for depression (ADS-K score) and anxiety (STAI-S, STAI-T and ASI-3 scores) were done before and one year after surgery. In addition SF36 physical composite score (PCS), Oswestry Disability Index (ODI) and pain visual analog scale (VAS) were completed preoperatively and one year postoperatively. Incidence and influence of these psychiatric comorbidities on clinical outcome were examined.

Results: 113 patients met all inclusion criteria. 64 patients were male (56.6%); the mean age was 60.1 years. Most patients were married or in a permanent relationship (77.0%). 75.2% had spinal instrumentation and 24.8 % underwent decompressive surgery. Abnormal STAI-S, STAI-T and ASI-3 anxiety scores were encountered preoperatively in 56.6%, 39.8% and 15.9%, in 36.3%, 23.0% and 8.0% at 3 months follow-up and in 33.6%, 31.0% and 11.5% one year after surgery, respectively. Only 2.6%, 5.3% and 4.4% of patients had abnormal STAI-S, STAI-T and ASI-3 anxiety scores after surgery alone, respectively. An abnormal ADK-S score was seen in 31.0% of cases before surgery and in 15.9% of cases at 1-year follow-up. Only 3.5 % of patients showed abnormal ADS-K scores following surgery alone. Patients with an anxiety disorder at follow-up also had a worse clinical outcome compared to their counterparts (ODI: 32.1 vs 18.4, P<0.001; VAS pain: 5.5 vs 3.5, P<0.001, PCS=34.5 vs. 41.0, P=0.009). Pathologic depression scores were also associated with a worse clinical outcome (ODI: 20.45 vs 5.2, P<0,001, VAS pain: 5.9 vs 3.8, P=0.001, PCS: 35.6 vs. 40.0,P=0.047).

Conclusions: The incidence of depression and anxiety disorders in patients undergoing elective spine surgery is very high. This was also associated with an unfavourable outcome one year after surgery. In most cases with mental comorbidities, these were already present prior to surgery and only a minority of patient developed problems after surgery.

Note: Ehab Shiban and Youssef Shiban contributed equally.