gms | German Medical Science

68th Annual Meeting of the German Society of Neurosurgery (DGNC)
7th Joint Meeting with the British Neurosurgical Society (SBNS)

German Society of Neurosurgery (DGNC)

14 - 17 May 2017, Magdeburg

Influence of the mental health status on a new measure of objective functional impairment in lumbar degenerative disc disease

Meeting Abstract

  • Martin N. Stienen - Klinik für Neurochirurgie, UniversitätsSpital Zürich, Zürich, Switzerland
  • Nicolas R. Smoll - Newcastle, Australia
  • Holger Joswig - St.Gallen, Switzerland
  • Jan Snagowski - Duisburg, Deutschland
  • Karl Schaller - Hôpitaux Universitaires de Genève, Neurochirurgie, Genève, Switzerland
  • Gerhard Hildebrandt - St.Gallen, Switzerland
  • Oliver P. Gautschi - Genf, Switzerland

Deutsche Gesellschaft für Neurochirurgie. Society of British Neurological Surgeons. 68. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), 7. Joint Meeting mit der Society of British Neurological Surgeons (SBNS). Magdeburg, 14.-17.05.2017. Düsseldorf: German Medical Science GMS Publishing House; 2017. DocDi.01.02

doi: 10.3205/17dgnc178, urn:nbn:de:0183-17dgnc1782

Published: June 9, 2017

© 2017 Stienen et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at



Objective: The Timed Up and Go (TUG) test has recently been proposed as a simple and standardized measure for objective functional impairment (OFI) in patients with lumbar degenerative disc disease (DDD). It was the objective to explore the relationship between a patient's mental health status and both patient-reported outcome measures (PROMs) and TUG test results.

Methods: Prospective IRB-approved two-center study. N=375 consecutive patients scheduled for lumbar spine surgery and a healthy cohort of n=110 control subjects. Patients and control subjects were assessed with the TUG test and a comprehensive panel of subjective PROMs of pain intensity (visual analogue scale (VAS)), functional impairment (Roland-Morris disability index (RMDI), Oswestry disability index (ODI)), as well as health-related quality of life (hrQoL; EuroQol (EQ)-5D). Standardized age- and sex-adjusted TUG test T-scores were calculated. The dependent variable was the short form (SF)-12 mental component summary (MCS) quartiles and the independent variables were the TUG T-scores and PROMs. Direct and adjusted analysis of covariance (ANCOVA) was performed to estimate the interaction between the SF-12 MCS quartiles and the independent variables.

Results: In patients, there was a significant decrease in the subjective PROMs, notably the VAS back pain (p=0.001) and VAS leg pain (0.035), as well as significant increase on the RMDI (p<0.001), ODI (p<0.001) and the EQ-5D index (p<0.001) with every increase in the quartile of the SF-12 MCS. There were no significant group differences of OFI as measured by the TUG T-scores across the SF-12 MCS quartiles (p=0.462). In the healthy control group, a significant decrease in VAS leg pain (p=0.028), RMDI (p=0.013) and ODI (p<0.001) as well as a significant increase in the EQ-5D index (p<0.001) was seen across the SF-12 MCS quartiles, whereas TUG T-scores remained stable (p=0.897).

Conclusion: There are significant influences of mental hrQoL on subjective measures of pain, functional impairment and hrQoL that might lead to bias when evaluating patients with lumbar DDD that suffer from reduced mental hrQoL. The TUG test appears to be a stable instrument and especially helpful in the evaluation of patients with lumbar DDD and mental health problems.