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Does anxiety influence the prognosis of percutaneous transforaminal endoscopic discectomy in the treatment of lumbar disc herniation? A preliminary propensity score matching analysis

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Abstract

Purpose

Previous reports revealed a correlation between psychological problems and spinal surgery. There is a lack of knowledge on the effect of anxiety on the percutaneous transforaminal endoscopic discectomy (PTED) outcome at the two year follow-up. The purpose of this study is to investigate changes in anxiety after PTED among patients with lumbar disc herniation (LDH), to compare the effect of anxiety on the prognosis using propensity score matching analysis, and to identify the related parameters of anxiety.

Methods

A total of 145 patients with LDH requiring PTED surgery were included. Twenty-six LDH patients with anxiety were matched with 26 control patients utilizing propensity score matching analysis. The demographic and peri-operative data were collected and analyzed. A correlation analysis was utilized.

Results

Both groups achieved significant improvements in visual analogue scale (VAS) scores for pain, Japanese Orthopedic Association (JOA) scores for neurological deficit, and 36-item Short-Form Health Survey (SF-36) scores and Oswestry Disability Index (ODI) scores for quality of life. A statistical difference was detected between the pre-operative and the post-operative Zung Self-Rating Anxiety Scale scores in the anxiety cohort. However, the difference between the anxiety group and the control group was statistically significant in the aforementioned parameters. The VAS, JOA, ODI and the SF-36 scores, and the disease duration were associated with pre-operative anxiety.

Conclusion

PTED may provide significant improvements in clinical outcomes and symptoms of anxiety. A negative impact on the patient’s prognosis may be caused by the presence of anxiety. Pain severity, neurological deficit, disease duration, and quality of life were associated with anxiety.

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Funding

This study was funded by the China Postdoctoral Science Foundation (2019M651588) and Cultivation Program for the National Natural Science Foundation of China from Shanghai Tenth People's Hospital (04. 03. 18. 081).

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Authors and Affiliations

  1. Department of Orthopedics, Shanghai Tenth People’s Hospital, Tongji University, Shanghai, 200072, People’s Republic of China

    Sheng Shi, Zhi Zhou, Hai-Jian Ni, Chuan-Feng Wang, Zhi-Min He & Shi-Sheng He

  2. Spinal Pain Research Institute, Tongji University School of Medicine, Shanghai, 200072, People’s Republic of China

    Sheng Shi, Zhi Zhou, Hai-Jian Ni, Chuan-Feng Wang, Zhi-Min He & Shi-Sheng He

  3. Department of Orthopedics, The Fifth Affiliated Hospital, Southern Medical University, Guangzhou, 510900, People’s Republic of China

    Yue-Hua Yang

  4. Department of Orthopedics, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, 310003, People’s Republic of China

    Jun-Hua Du & Jun-Song Wu

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  1. Sheng Shi
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Correspondence to Shi-Sheng He.

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Ethical approval

The manuscript submitted does not contain information about medical device(s)/drug(s). This study was approved by the ethics department of Shanghai Tenth People's Hospital (SHSY-IEC-4.1/20-27/01).

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Shi, S., Zhou, Z., Ni, HJ. et al. Does anxiety influence the prognosis of percutaneous transforaminal endoscopic discectomy in the treatment of lumbar disc herniation? A preliminary propensity score matching analysis. International Orthopaedics (SICOT) 44, 2357–2363 (2020). https://doi.org/10.1007/s00264-020-04656-0

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  • DOI: https://doi.org/10.1007/s00264-020-04656-0

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