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

• Published in: Clinics in orthopedic surgery Vol. 9; no. 2; pp. 177 - 183
• Main Authors: Lee, Jaewon, Kim, Hong-Sik, Shim, Kyu-Dong, Park, Ye-Soo
• Format: Journal Article
• Language: English
• Published: Korea (South) The Korean Orthopaedic Association 01.06.2017; 대한정형외과학회
• Subjects: Aged; Anxiety - complications; Anxiety - epidemiology; Anxiety - psychology; Depression - complications; Depression - epidemiology; Depression - psychology; Female; Humans; Lumbar Vertebrae - surgery; Male; Middle Aged; Optimism - psychology; Original; Patient Satisfaction - statistics & numerical data; Postoperative Complications; Retrospective Studies; Spinal Stenosis - complications; Spinal Stenosis - epidemiology; Spinal Stenosis - psychology; Spinal Stenosis - surgery; Spondylolisthesis - epidemiology; Spondylolisthesis - psychology; Spondylolisthesis - surgery; Treatment Outcome; 정형외과학; Psychological status; Lumbar spine; Retrospective cohort study; Clinical outcomes
• ISSN: 2005-291X; 2005-4408; 2005-4408
• DOI: 10.4055/cios.2017.9.2.177

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. 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. VAS and ODI scores significantly decreased after surgery ( < 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. 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.