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The prevalence of depressive symptoms before and after surgery and its association with disability in patients undergoing lumbar spinal fusion

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Abstract

Purpose

The aim of this study was to evaluate the prevalence of depressive symptoms and disability pre-operatively, at 3 months and at 1 year after lumbar spine fusion surgery.

Methods

Data was extracted from a dedicated lumbar spine fusion register, giving 232 patients (mean age 62 years, 158 females) who had undergone instrumented lumbar spine fusion. The frequency of depressive symptoms and disability was evaluated using the Depression Scale (DEPS) and Oswestry Disability Index (ODI).

Results

Depressive symptoms were found in 34, 13, and 15 % of the patients pre-operatively, at 3 months and at 1 year after surgery, respectively. The mean DEPS score decreased from 16.2 to 8.6 (p < 0.001) in patients who had depressive symptoms pre-operatively, and from 6.1 to 3.8 (p < 0.001) in those patients without pre-operative depressive symptoms. The mean ODI values pre-operatively, at 3 months and at 1 year after surgery were 53, 30, and 23, respectively, in patients with pre-operative depressive symptoms and 41, 23, and 20 in those patients without pre-operative depressive symptoms. The differences between the groups were statistically significant at all time points (p < 0.001).

Conclusions

One-third of our patients with chronic back pain undergoing spinal fusion had depressive symptoms pre-operatively. The prevalence of depressive symptoms decreased after surgery. Although disability remained higher in those patients who had reported depressive symptoms pre-operatively, disability did decrease significantly in both groups post-operatively. Thus, there is no need to exclude depressive patients from operation, but screening measures and appropriate treatment practises throughout both pre-operative and post-operative periods are encouraged.

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Acknowledgments

The authors thank Tampere University Hospital and Jyväskylä Central Hospital spine register teams, especially Liisa Pekkanen, Kati Kyrölä, Kirsi Piitulainen and Seija Rautiainen for collecting the register data. We also thank Virginia Mattila and Honorary Professor Associate Ian McDermott for editing English language of this manuscript. The study was supported by Medical Research Funds from Tampere University Hospital and Jyväskylä Central Hospital, Finland.

Conflict of interest

None.

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Authors and Affiliations

  1. Department of Orthopaedic and Trauma Surgery, Tampere University Hospital, Tampere, Finland

    Marko Wahlman, Ilkka Marttinen, Kimmo Vihtonen & Marko H. Neva

  2. Department of Health Sciences, University of Jyväskylä, Jyväskylä, Finland

    Arja Häkkinen

  3. Department of Physical Medicine, Jyväskylä Central Hospital, Jyväskylä, Finland

    Arja Häkkinen

  4. Department of Rehabilitation Medicine and Department of Psychiatry, VY University Medical Center, Amsterdam, The Netherlands

    Joost Dekker

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  1. Marko Wahlman
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  2. Arja Häkkinen
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Correspondence to Marko Wahlman.

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Wahlman, M., Häkkinen, A., Dekker, J. et al. The prevalence of depressive symptoms before and after surgery and its association with disability in patients undergoing lumbar spinal fusion. Eur Spine J 23, 129–134 (2014). https://doi.org/10.1007/s00586-013-2896-0

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  • DOI: https://doi.org/10.1007/s00586-013-2896-0

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