Skip to main content

Advertisement

SpringerLink
Log in

Life dissatisfaction is associated with a poorer surgery outcome and depression among lumbar spinal stenosis patients: a 2-year prospective study

  • Original Article
  • Published:
European Spine Journal Aims and scope Submit manuscript

Abstract

The aim of this study was to examine the life satisfaction of lumbar spinal stenosis (LSS) patients up to the 2-year postoperative phase. Patients (N = 102, mean age, 62 years) with symptomatic LSS underwent decompressive surgery. Data collection took place with the same set of questionnaires before surgery and 3 months, 6 months, 1 year and 2 years postoperatively. Life satisfaction was assessed with the four-item Life Satisfaction scale and depression symptoms with the 21-item Beck Depression Inventory (BDI). In addition, a depression burden variable was included, comprising the sum of preoperative, 3- and 6-month BDI scores. Physical functioning and pain were assessed with the Oswestry disability index, Stucki questionnaire, self-reported walking ability, visual analogy scale and pain drawing. Two years postoperatively, 18% of the LSS patients was dissatisfied with their lives. As a whole, the life satisfaction of the LSS patients improved during the postoperative follow-up, reaching the level of the healthy adult Finnish population. However, 2 years postoperatively, dissatisfied patients reported significantly more pain, a poorer functional ability and more depressive symptoms and depression than the patients who were satisfied with life. This difference was seen throughout the postoperative follow up. In regression analyses, the only significant associations were between the depression burden and postoperative life dissatisfaction. Thus, subjective well-being as well as depression among LSS patients should be assessed pre- and postoperatively in order to enable early intervention for those at risk of poorer life satisfaction.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Allardt E (1973) About dimension of welfare: an explanatory analysis of the comparative Scandinavian survey. Research Reports 1, Research Group of Comparative Sociology, University of Helsinki, Finland

    Google Scholar 

  2. Amundsen T, Weber H, Nordal HJ, Magnaes B, Abdelnoor M, Lilleås F (2000) Lumbar spinal stenosis: conservative or surgical management? A prospective 10-year study. Spine 25:1424–1435. doi:10.1097/00007632-200006010-00016

    Article  PubMed  CAS  Google Scholar 

  3. Atlas SJ, Keller RB, Robson D, Deyo RA, Singer DE (2000) Surgical and nonsurgical management of lumbar spinal stenosis: four-year outcomes from the Maine Lumbar Spine Study. Spine 25:556–562. doi:10.1097/00007632-200003010-00005

    Article  PubMed  CAS  Google Scholar 

  4. Bombardier C (2000) Outcome assessments in the evaluation of treatment of spinal disorders: summary and general recommendations. Spine 15:3100–3103. doi:10.1097/00007632-200012150-00003

    Article  Google Scholar 

  5. Beck AT, Ward CH, Mendelson M, Mock J, Erbaugh J (1961) An inventory for measuring depression. Arch Gen Psychiatry 4:561–571

    PubMed  CAS  Google Scholar 

  6. Bromberger JT, Kravitz HM, Wei HL, Brown C, Youk AO, Cordal A, Powell LH, Matthews KA (2005) History of depression and women’s current health and functioning during midlife. Gen Hosp Psychiatry 27:200–208. doi:10.1016/j.genhosppsych.2005.01.007

    Article  PubMed  Google Scholar 

  7. Deyo RA, Battie M, Beurskens AJ, Bombardier C, Croft P, Koes B, Malmivaara A, Roland M, Von Korff M, Waddell G (1998) Outcome measures for low back pain research. A proposal for standardized use. Spine 15:2003–20013. doi:10.1097/00007632-199809150-00018

    Article  Google Scholar 

  8. Fairbank JCT, Pynsent PB (2000) The Oswestry disability index. Spine 25:2940–2953. doi:10.1097/00007632-200011150-00017

    Article  PubMed  CAS  Google Scholar 

  9. Fairbank JCT, Davies JB, Couper J et al (1980) The Oswestry low back pain disability questionnaire. Physiotherapy 66:271–273

    PubMed  CAS  Google Scholar 

  10. Grönblad M, Hupli M, Wennerstrand P, Järvinen E, Lukinmaa A, Kouri JP, Karaharju EO (1993) Intercorrelations and re-test reliability of the pain disability index (PDI) and the oswestry disability questionnaire (ODQ) and their correlation with pain intensity in low back pain patients. Clin J Pain 9:189–195

    Article  PubMed  Google Scholar 

  11. Haefeli M, Elfering A, Aebi M, Freeman BJ, Fritzell P, Guimaraes Consciencia J, Lamartina C, Mayer M, Lund T, Boos N (2008) What comprises a good outcome in spinal surgery? A preliminary survey among spine surgeons of the SSE and European spine patients. Eur Spine J 17:104–116. doi:10.1007/s00586-007-0541-5

    Article  PubMed  CAS  Google Scholar 

  12. Haro H, Maekawa S, Hamada Y (2008) Prospective analysis of clinical evaluation and self-assessment by patients after decompression surgery for degenerative lumbar canal stenosis. Spine J 8:380–384. doi:10.1016/j.spinee.2007.01.010

    Article  PubMed  Google Scholar 

  13. Hornquist JO, Hansson B, Åkerlind I, Larsson J (1992) Severity of disease and quality of life: a comparison in patients with cancer and benign disease. Qual Life Res 1:135–141. doi:10.1007/BF00439721

    Article  PubMed  CAS  Google Scholar 

  14. Jönsson B, Annertz M, Sjöberg C, Strömqvist B (1997) A prospective and consecutive study of surgically treated lumbar spinal stenosis. Part II: Five-year follow-up by an independent observer. Spine 22:2938–2944. doi:10.1097/00007632-199712150-00017

    Article  PubMed  Google Scholar 

  15. Kelly-Hayes M, Jette AM, Wolf PA, D’Agostino RB, Odell PM (1992) Functional limitations and disability among elders in the Framingham study. Am J Public Health 82:841–845. doi:10.2105/AJPH.82.6.841

    Article  PubMed  CAS  Google Scholar 

  16. Koivumaa-Honkanen H, Viinamäki H, Honkanen R, Tanskanen A, Antikainen R, Niskanen L, Jääskeläinen J, Lehtonen J (1996) Correlates of life-satisfaction among psychiatric patients. Acta Psychiatr Scand 94:372–378. doi:10.1111/j.1600-0447.1996.tb09875.x

    Article  PubMed  CAS  Google Scholar 

  17. Koivumaa-Honkanen H (1998) Life satisfaction as a health predictor. Medical Sciences publication no D143. Kuopio University Publications, Kuopio

    Google Scholar 

  18. Koivumaa-Honkanen H, Honkanen R, Antikainen R, Hintikka J, Laukkanen E, Honkalampi K, Viinamäki H (2001) Self-reported life satisfaction and recovery from depression in a 1-year prospective study. Acta Psychiatr Scand 103:38–44. doi:10.1034/j.1600-0447.2001.00046.x

    Article  PubMed  CAS  Google Scholar 

  19. Koivumaa-Honkanen H, Honkanen R, Koskenvuo M, Viinamäki H, Kaprio J (2002) Life dissatisfaction as a predictor of fatal injuries in 20-year of follow-up. Acta Psychiatr Scand 105:444–450. doi:10.1034/j.1600-0447.2002.01287.x

    Article  PubMed  CAS  Google Scholar 

  20. Koivumaa-Honkanen H, Honkanen R, Viinamäki Heikkilä K, Kaprio J, Koskenvuo M (2000) Self-reported life satisfaction and 20-year mortality in healthy Finnish adults. Am J Epidemiol 152:983–991. doi:10.1093/aje/152.10.983

    Article  PubMed  CAS  Google Scholar 

  21. Koivumaa-Honkanen H, Honkanen R, Viinamäki H, Heikkilä K, Kaprio J, Koskenvuo M (2001) Life satisfaction and suicide: a 20-year follow-up study. Am J Psychiatry 158:433–439. doi:10.1176/appi.ajp.158.3.433

    Article  PubMed  CAS  Google Scholar 

  22. Koivumaa-Honkanen H, Kaprio J, Honkanen R, Viinamäki H, Koskenvuo M (2004) Life satisfaction and depression in a 15-year follow-up of healthy adults. Soc Psychiatry Psychiatr Epidemiol 38:994–999. doi:10.1007/s00127-004-0833-6

    Article  Google Scholar 

  23. Koivumaa-Honkanen H, Kaprio J, Honkanen RJ, Viinamäki H, Koskenvuo M (2005) The stability of life satisfaction in a 15-year follow-up of adult Finns healthy at baseline. BMC Psychiatry 5:4. doi:10.1186/1471-244X-5-4

    Article  PubMed  Google Scholar 

  24. Koivumaa-Honkanen H, Koskenvuo M, Honkanen R, Viinamäki H, Kaprio J (2004) Life dissatisfaction and subsequent work disability pension in an 11-year follow-up. Psychol Med 34:221–228. doi:10.1017/S0033291703001089

    Article  PubMed  CAS  Google Scholar 

  25. Kozma A, Stones MJ (1987) Social desirability in measures of subjective well-being: A systematic evaluation. J Gerontol 42:56–59

    PubMed  CAS  Google Scholar 

  26. Mannion A, Elfering A, Staerkle R, Junge A, Grob D, Dvorak J, Jacobshagen N, Semmer N, Boos N (2007) Predictors of multidimensional outcome after spinal surgery. Eur Spine J 16:777–786. doi:10.1007/s00586-006-0255-0

    Article  PubMed  CAS  Google Scholar 

  27. Margolis RB, Tait RC, Krause SJ (1986) Rating system for use with patient pain drawings. Pain 24:57–65. doi:10.1016/0304-3959(86)90026-6

    Article  PubMed  CAS  Google Scholar 

  28. McDowell I, Newell C (eds) (1996) Measuring health: a guide to rating scales and questionnaires, 2nd edn. Oxford University Press, New York

  29. Price DD, McGrath PA, Rafii A, Buckingham B (1983) The validation of visual analogue scales as ratio scale measures for chronic and experimental pain. Pain 17:45–56. doi:10.1016/0304-3959(83)90126-4

    Article  PubMed  CAS  Google Scholar 

  30. Raitasalo R (1977) Depression and its association with the need for psychotherapy (article in Finnish). The Social Insurance Institute of Finland publications A13, Helsinki

    Google Scholar 

  31. Rowe SK, Rapaport MH (2006) Classification and treatment of sub-threshold depression. Curr Opin Psychiatry 19:9–13. doi:10.1097/01.yco.0000194148.26766.ba

    Article  PubMed  Google Scholar 

  32. Sainio P, Koskinen S, Heliövaara M, Martelin T, Härkänen T, Hurri H, Miilunpalo S, Aromaa A (2006) Self-reported and test-based mobility limitations in a representative sample of Finns aged 30+. Scand J Public Health 34:378–386. doi:10.1080/14034940500489859

    Article  PubMed  Google Scholar 

  33. Sechrest L, McKnight P, McKnight K (1996) Calibration of measures for psychotherapy outcome studies. Am Psychol 51:1065–1071. doi:10.1037/0003-066X.51.10.1065

    Article  PubMed  CAS  Google Scholar 

  34. Sinikallio S, Aalto T, Airaksinen O, Herno A, Kröger H, Savolainen S, Turunen V, Viinamäki H (2006) Depression and associated factors in patients with lumbar spinal stenosis. Disabil Rehabil 28:415–422. doi:10.1080/09638280500192462

    Article  PubMed  Google Scholar 

  35. Sinikallio S, Aalto T, Airaksinen O, Herno A, Kröger H, Savolainen S, Turunen V, Viinamäki H (2007) Somatic comorbidity and younger age are associated with life dissatisfaction among patients with lumbar spinal stenosis before surgical treatment. Eur Spine J 16:857–864. doi:10.1007/s00586-006-0080-5

    Article  PubMed  Google Scholar 

  36. Stucki G (1996) Measurement properties of a self-administered outcome measure in lumbar spinal stenosis. Spine 21:796–803. doi:10.1097/00007632-199604010-00004

    Article  PubMed  CAS  Google Scholar 

  37. Tuomi K, Ilmarinen J, Jahkola A, Katajarinne L, Tulkki A (1998) An approved version of the work ability index. Occupational Health Services 19. Finnish Institute of Occupational Health, Helsinki

    Google Scholar 

  38. Vaillant G (2003) Mental health. Am J Psychiatry 160:1373–1384. doi:10.1176/appi.ajp.160.8.1373

    Article  PubMed  Google Scholar 

  39. Viinamäki H, Tanskanen A, Honkalampi K, Koivumaa-Honkanen HT, Haatainen K, Kaustio O, Hintikka J (2004) Is the beck depression inventory suitable for screening major depression in different phases of the disease? Nord J Psychiatry 58:49–53. doi:10.1080/08039480310000798

    Article  PubMed  Google Scholar 

  40. Weinstein JN, Tosteson TD, Lurie JD, Tosteson AN, Blood E, Hanscom B, Herkowitz H, Cammisa F, Albert T, Boden SD, Hilibrand A, Goldberg H, Berven S, An H, Investigators SPORT (2008) Surgical versus non-surgical therapy for lumbar spinal stenosis. N Engl J Med 358:794–810. doi:10.1056/NEJMoa0707136

    Article  PubMed  CAS  Google Scholar 

Download references

Acknowledgements

S. Sinikallio was supported by a Kuopio University Hospital EVO research grant and a research grant from the Signe and Ane Gyllenberg Foundation. This study was approved by the Ethics Committee of University of Kuopio and Kuopio University Hospital, Finland.

Author information

Authors and Affiliations

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

    Sanna Sinikallio

  2. Kyyhkylä Rehabilitation Center, Mikkeli, Finland

    Timo Aalto

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

    Timo Aalto, Olavi Airaksinen & Arto Herno

  4. Department of Psychiatry, University of Oulu, Oulu, Finland

    Heli Koivumaa-Honkanen

  5. Department of Psychiatry, Lapland Hospital District, Muurola, Finland

    Heli Koivumaa-Honkanen

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

    Heli Koivumaa-Honkanen & Heimo Viinamäki

  7. Department of Orthopaedics and Traumatology, Kuopio University Hospital, Kuopio, Finland

    Heikki Kröger

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

    Heikki Kröger

  9. Kuopio University, Kuopio, Finland

    Heimo Viinamäki

Authors
  1. Sanna Sinikallio
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Timo Aalto
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Heli Koivumaa-Honkanen
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Olavi Airaksinen
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Arto Herno
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Heikki Kröger
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Heimo Viinamäki
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Sanna Sinikallio.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Sinikallio, S., Aalto, T., Koivumaa-Honkanen, H. et al. Life dissatisfaction is associated with a poorer surgery outcome and depression among lumbar spinal stenosis patients: a 2-year prospective study. Eur Spine J 18, 1187–1193 (2009). https://doi.org/10.1007/s00586-009-0955-3

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00586-009-0955-3

Keywords

Search

Navigation