Preoperative psychological factors associated with the postoperative outcome of degenerative lumbar disc herniation

English Keywords:Degenerative lumbar disc herniation  Depression  Ａnxiety  Psychological assessment  Postoperative outcome

English Abstract:

  【Abstract】 Objective：To investigate the correlation of depression and anxiety and postoperative pain degree for degenerative lumbar disc herniation，and to evaluate these preoperative psychological factors on postoperative outcome.Method：40 cases with degenerative lumbar disc herniation undergoing surgery in our institute from March 2008 to March 2010 were reviewed retrospectively.JOA（Japanese Orthopedic Association） scores，ＶAS（visual analog scale） scores，Hamilton depression scale scores of 17 versions and Hamilton anxiety scale scores of 14 versions were performed on all patients.Based on the Hamilton depression scale score（over or less than 7），all patients were classified into depression group and nondepression group.Again all patients were classified into anxiety group and non anxiety group based on the Hamilton anxiety scale score（over or less than 6）.3 months after operation all patients were followed up for JOA and VAS scores.The pain relief of depression and nondepression group and anxiety and non anxiety group was compared retrospectively.Result：Ｔｈｅ　ＪＯＡ　ｓｃｏｒｅs　ｏｆ　ｄｅｐｒｅｓｓｉｏｎ　ｇｒｏｕｐ，ｎｏｎｄｅｐｒｅｓｓｉｏｎ　ｇｒｏｕｐ，ａｎｘｉｅｔｙ　ｇｒｏｕｐ　ａｎｄ　ｎｏn ａｎｘｉｅｔｙ　ｇｒｏｕｐ　ａｒｅ　3.2±0.3，9.1±1.8，3.3±0.3　ａｎｄ　9.2±1.9．Ｔｈｅ　ＶＡＳ　ｓｃｏｒｅs　ｏｆ　ｔｈｅｍ　ａｒｅ　1.25±0.53，2.53±0.40，1.23±0.55　ａｎｄ　2.48±0.38．The postoperative pain relief of depress group and anxiety group was less than other groups（P<0.01）.Conclusion：The preoperative negative emotion（presenting with depression and anxiety） proves unfavorable to pain relief of lumbar disc herniation, and preoperative psychological evaluation will help to prognostic assessment.