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Depression is associated with poorer outcome of lumbar spinal stenosis surgery

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Abstract

The objective of this observational prospective study was to investigate the effect of depression on short-term outcome after lumbar spinal stenosis (LSS) surgery. Surgery was performed on 99 patients with clinically and radiologically defined LSS, representing ordinary LSS patients treated at the secondary care level. They completed questionnaires before surgery and 3 months postoperatively. Depression was assessed with the 21-item Beck Depression Inventory (BDI). Physical functioning and pain were assessed with Oswestry disability index, Stucki Questionnaire, self-reported walking ability, visual analogue scale (VAS) and pain drawing. Preoperatively, 20% of the patients had depression. In logistic regression analyses, significant associations were seen between preoperative depression and postoperative high Oswestry disability and Stucki severity scores and high intensity of pain (VAS score). In subsequent analyses, the patients with continuous depression, measured with BDI (60% of the patients who had preoperative depression), showed fewer improvements in symptom severity, disability score, pain intensity and walking capacity than the patients who did not experience depression at any phase. In those patients who recovered from depression, according to BDI-scores (35% of the patients with preoperative depression), the postoperative improvement was rather similar to the improvement seen in the normal mood group. In the surgical treatment of LSS, we recommend that the clinical practice should include an assessment of depression.

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Acknowledgments

We thank Ewen MacDonald, Ph.D. (University of Kuopio, Department of Pharmacology and Toxicology) for language checking. S. Sinikallio wishes to thank the Kuopio University Hospital for EVO research grant. The study design was reviewed and approved by the Ethics Committee of University of Kuopio and Kuopio University Hospital, Finland, and experiments were in compliance with Finnish law.

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Authors and Affiliations

  1. Department of Rehabilitation (2981), Kuopio University Hospital, Tarinan sairaala, 71800, Siilinjärvi, Finland

    Sanna Sinikallio

  2. Department of Physical Medicine and Rehabilitation, Kuopio University Hospital, Kuopio, Finland

    Timo Aalto, Olavi Airaksinen & Arto Herno

  3. Department of Surgery/Orthopaedics, Kuopio University Hospital, Kuopio, Finland

    Heikki Kröger & Veli Turunen

  4. The Bone and Cartilage Research Unit, Kuopio University, Kuopio, Finland

    Heikki Kröger

  5. Department of Neurosurgery, Kuopio University Hospital, Kuopio, Finland

    Sakari Savolainen

  6. Department of Psychiatry, Kuopio University and Kuopio University Hospital, Kuopio, Finland

    Heimo Viinamäki

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  1. Sanna Sinikallio
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  2. Timo Aalto
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  3. Olavi Airaksinen
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  4. Arto Herno
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  5. Heikki Kröger
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  6. Sakari Savolainen
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  7. Veli Turunen
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  8. Heimo Viinamäki
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Correspondence to Sanna Sinikallio.

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Sinikallio, S., Aalto, T., Airaksinen, O. et al. Depression is associated with poorer outcome of lumbar spinal stenosis surgery. Eur Spine J 16, 905–912 (2007). https://doi.org/10.1007/s00586-007-0349-3

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  • DOI: https://doi.org/10.1007/s00586-007-0349-3

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