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67th Annual Meeting of the German Society of Neurosurgery (DGNC)
Joint Meeting with the Korean Neurosurgical Society (KNS)

German Society of Neurosurgery (DGNC)

12 - 15 June 2016, Frankfurt am Main

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Post traumatic stress disorder symptoms following elective spine surgery – surgery is not the reason

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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.19.03

doi: 10.3205/16dgnc351, urn:nbn:de:0183-16dgnc3513

Published: June 8, 2016

© 2016 Shiban et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.

Outline

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Objective: Recently, posttraumatic stress disorder symptoms (PTSD) were attributed to spine surgery. Furthermore, PTSD symptoms were associated with reduced clinical benefit. However, PTSD is seen in up to 10% of the normal population and there was no preoperative evaluation for PTSD symptoms. The aim of this study is to evaluate the incidence of PTSD before and after elective spine surgery and the influence on clinical outcome.

Method: A prospective study of patients undergoing elective spine surgery for degenerative disc disease was performed. The patients were evaluated for PTSD using the PTSS score before and one year after surgery. In addition the SF36 physical composite score (PCS), the Oswestry Disability Index (ODI) and a pain visual analog scale (VAS) were completed preoperatively and one year after surgery. The incidence and influence of PTSD symptoms on clinical outcome were examined.

Results: 113 patients met all inclusion criteria. 64 patients were male (56.6%); mean age was 60.1 years. 75.2% underwent a spinal instrumentation and 24.8% had decompressive surgery. PTSD symptoms were reported in 51 patients (45%) before surgery. However, only 19 patients (16.8%) still had abnormal PTSS scores at 1 year follow-up. Only 3 patients (2.7%) developed PTSD symptoms following surgery. Before surgery the presence or absence of PTSD symptoms had no influence on clinical outcome. At the 1-year follow-up, patients with PTSD symptoms had a worse clinical outcome (PCS: 33.7 vs. 40.0, P=0.039; pain VAS: 5.8 vs. 3.7, P=0.001; ODI: 31.7 vs. 20.3, P=0.012).

Conclusions: PTSD symptoms are associated with a worse outcome following elective spine surgery. However, the vast majority of patients that exhibit PTSD symptoms had already exhibited symptoms before surgery and only a small minority develop PTSD symptoms after surgery.

Note: Ehab Shiban and Youssef Shiban contributed equally.