Clin Orthop Surg.  2017 Jun;9(2):177-183. 10.4055/cios.2017.9.2.177.

The Effect of Anxiety, Depression, and Optimism on Postoperative Satisfaction and Clinical Outcomes in Lumbar Spinal Stenosis and Degenerative Spondylolisthesis Patients: Cohort Study

• Lee J
• Kim HS
• Shim KD
• Park YS

• KMID: 2412285
• DOI: http://doi.org/10.4055/cios.2017.9.2.177

Abstract

BACKGROUND
The aim of this study is to evaluate the effect of depression, anxiety, and optimism on postoperative satisfaction and clinical outcomes in patients who underwent less than two-level posterior instrumented fusions for lumbar spinal stenosis and degenerative spondylolisthesis.
METHODS
Preoperative psychological status of subjects, such as depression, anxiety, and optimism, was evaluated using the Hospital Anxiety and Depression Scale (HADS) and the Revised Life Orientation Test (LOT-R). Clinical evaluation was determined by measuring changes in a visual analogue scale (VAS) and the Oswestry Disability Index (ODI) before and after surgery. Postoperative satisfaction of subjects assessed using the North American Spine Society lumbar spine questionnaire was comparatively analyzed against the preoperative psychological status. The correlation between patient's preoperative psychological status (depression, anxiety, and optimism) and clinical outcomes (VAS and ODI) was evaluated.
RESULTS
VAS and ODI scores significantly decreased after surgery (p < 0.001), suggesting clinically favorable outcomes. Preoperative psychological status of patients (anxiety, depression, and optimism) was not related to the degree of improvement in clinical outcomes (VAS and ODI) after surgery. However, postoperative satisfaction was moderately correlated with optimism.
CONCLUSIONS
Anxiety and optimism were more correlated with patient satisfaction than clinical outcomes. Accordingly, the surgeon can predict postoperative satisfaction of patients based on careful evaluation of psychological status before surgery.

Keyword

Lumbar spine; Clinical outcomes; Retrospective cohort study; Psychological status

MeSH Terms

Aged
*Anxiety/complications/epidemiology/psychology
*Depression/complications/epidemiology/psychology
Female
Humans
Lumbar Vertebrae/surgery
Male
Middle Aged
Optimism/*psychology
Patient Satisfaction/*statistics & numerical data
Postoperative Complications
Retrospective Studies
*Spinal Stenosis/complications/epidemiology/psychology/surgery
*Spondylolisthesis/epidemiology/psychology/surgery
Treatment Outcome

Figure

• 

  Fig. 1 Flow diagram illustrating study design. VAS: visual analogue scale, ODI: Oswestry Disability Index, HADS: Hospital Anxiety and Depression Scale, LOT-R: Revised Life Orientation Test, NASS: North American Spine Society.

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