Summary
57 patients who were operated upon for the first time for slipped lumbar disk have been investigated in a prospective blind follow-up design. In both the preoperative and postoperative evaluation objective as well as subjective conditions have been considered, and the surgeons have not re-examined the patients. There is a 100% follow-up of the patients. We found that the following preoperative conditions are associated with surgical outcome, 6 and 24 months postoperatively: Medical parameters like statement of pain and surgical findings; social parameters such as being employed, duration of education, and whether you get sufficient social support from family and friends; duration of sick-leave, actions for damages, and number of life events. Psychological parameters such as pain drawing and the MMPI-scales: F, K, Hs, D, Hy, Pa, Pt, Sc, Ma, and Ad. In the statistical analysis multiple linear regression analysis is used, which allows evaluation of the different parameters compared with each other. It is found that conditions such as being employed, increase of the MMPI-scale Ad, alone could explain the 42% difference in surgical outcome. Good outcome is correctly predicted in 88% of the cases with observed good outcome. Poor outcome is correctly predicted in 54% of the cases with observed poor outcome.
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References
Blumetti AE, Modesti LM (1976) Psychological predictors of success or failure of surgical intervention for intractable back pain. Adv Pain Res Ther 1: 323–325
Carlsson AM (1983) Assessment of chronic pain. I. Aspects of the reliability and validity of the visual analogue scale. Pain 16: 87–101
Dzioba JO, Doxey NC (1984) A prospective investigation into the orthopaedic and psychological predictors of outcome of first lumbar surgery following industrial injury. Spine 9: 614–623
Espersen JO, Kosteljanetz M, Halaburt M, Miletic T (1984) Predictive value of radiculography in patients with lumbagosciatica. A prospective study (part II). Acta Neurochir (Wien) 73: 213–221
Greene RL (1980) The MMPI. An interpretive manual. Grune & Stratton Inc, New York, pp 1–306
Gross AR (1986) The effect of coping strategies of the relief of pain following surgical intervention for lower back pain. Psychosom Med 48: 229–241
Holmes TH, Rahe RH (1967) The social readjustment rating scale. J Psychosom Res 11: 213–218
Innovative Software, Inc (1986). SMART version 3.10
Kosteljanetz M, Espersen JO, Halaburt H, Miletic T (1984) Predictive value of clinical and surgical findings in patients with lumbago-sciatica. A prospective study (part I). Acta Neurochir (Wien) 73: 67–76
Kuperman SK, Osmon D, Golden CJ, Blume HG (1979) Prediction of neurosurgical results by psycholocal evaluation. Perceptual and Motor Skills 48: 311–315
Little KB, Fisher J (1958) Two new experimental scales of the MMPI. J Consult Psychol 22: 305–306
Long CJ, Brown DA, Engelberg J (1980) Intervertebral disc surgery. Strategies for patient selection to improve surgical outcome. J Neurosurg 52: 818–824
Long CJ (1981) The relationship between surgical outcome and MMPI profiles in chronic pain patients. J Clin Psychol 37: 744–749
Oostdam EMM, Duivenvoorden HJ, Pondag W (1981) Predictive value of some psychological tests on the outcome of surgical intervention in low back pain patients. J Psychosom Res 25: 227–235
Oostdam EMM, Duivenvoorden HJ (1983) Predictability of the result of surgical intervention in patients with low back pain. J Psychosom Res 27: 272–281
Pheasant HC, Gilbert D, Goldfarb J, Herron L (1979) The MMPI as a predictor of outcome in low back surgery. Spine 4: 78–84
Randford AO, Cairns D, Mooney V (1976) The pain drawing as an aid to the psychological evaluation of patients with lowback pain. Spine 1: 127–134
Taylor WP, Stern WR, Kybiszyn TW (1984) Predicting patients' perceptions of response to treatment for low-back pain. Spine 9: 313–316
Turner JA, Heron L, Weiner P (1986) Utility of the MMPI pain assessment index in predicting outcome after lumbar surgery. J Clin Psychol 42: 746–769
Villard HP, Imbeault J, Duguay M (1986) Low back pain: a psychosomatic clinical study. Psychother Psychosom 45: 78–83
Waring EM, Weisz GM, Bailey SI (1976) Predictive factors in the treatment of low back pain by surgical intervention. Adv Pain Res Ther 1: 939–942
Weber H (1983) Lumbar disc herniation. A controlled, prospective study with ten years of observation. Spine 8: 131–140
Wulff HR, Schlichting P (1987) Astra-gruppen A/S. MEDSTAT. Version 1.0
Sørensen LV, Mors O (1987) A prospective study of the importance of psychological and social factors for the outcome after surgery in patients with slipped lumbar disk operated upon for the first time. Acta Neurochir (Wien) 88: 119–125
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Sørensen, L.V., Mors, O. A two-year prospective follow-up study of the outcome after surgery in patients with slipped lumbar disk operated upon for the first time. Acta neurochir 96, 94–99 (1989). https://doi.org/10.1007/BF01456165
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DOI: https://doi.org/10.1007/BF01456165