Original Article

European Spine Journal

, Volume 18, Issue 8, pp 1187-1193

First online:

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

  • Sanna SinikallioAffiliated withDepartment of Rehabilitation, Kuopio University Hospital Email author 
  • , Timo AaltoAffiliated withKyyhkylä Rehabilitation CenterDepartment of Physical and Rehabilitation Medicine, Kuopio University Hospital
  • , Heli Koivumaa-HonkanenAffiliated withDepartment of Psychiatry, University of OuluDepartment of Psychiatry, Lapland Hospital DistrictDepartment of Psychiatry, Kuopio University Hospital
  • , Olavi AiraksinenAffiliated withDepartment of Physical and Rehabilitation Medicine, Kuopio University Hospital
  • , Arto HernoAffiliated withDepartment of Physical and Rehabilitation Medicine, Kuopio University Hospital
  • , Heikki KrögerAffiliated withDepartment of Orthopaedics and Traumatology, Kuopio University HospitalThe Bone and Cartilage Research Unit, Kuopio University
  • , Heimo ViinamäkiAffiliated withDepartment of Psychiatry, Kuopio University HospitalKuopio University

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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.

Keywords

Spinal stenosis Life satisfaction Surgery outcome 2-Year follow-up Depressive symptoms