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Predicting Quality of Life After Lumbar Spondylodesis

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Abstract

Quality of life after spondylodesis was predicted by pretreatment psychological variables and findings in a standardized physical examination. Four quality-of-life criteria were used: functional capacity, vocational rehabilitation, satisfaction with the outcome of the operation, and pain intensity recorded in a pain diary. Those of six presurgery variables that proved to be associated with the outcome 9 months postsurgery, by means of a multiple stepwise regression procedure, were selected for discriminant analyses. The sample consisted of 50 consecutive patients who underwent either ventral (n = 10) or posterolateral (n = 40) spondylodesis with or without posterior instrumentation. Their average age was 44.9 years (SD = 12.9) with an average duration of pain of 8.6 years (SD = 8.8). Nearly half of the patients had had previous spine surgery. Follow-up data indicate that about half of the patients show a beneficial outcome in terms of quality-of-life measures. Discriminant analyses suggest that poor presurgical functional capacity and an unclear finding in the physical examination before surgery contribute to our knowledge about patients who are likely to show continuous pain and poor functional capacity after surgery.

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REFERENCES

  • Aaronson, N. K. (1988). Quality of life: what is it? How should it be measured? Oncology, 2, 69–76.

    Google Scholar 

  • Backhaus, K., Erichson, B., Plinke, W., & Wiber, R. (1990). Multivariate Analysemethoden. Eine anwendungsorientierte Einführung. Berlin: Springer.

    Google Scholar 

  • Bortz, J. (1993). Statistik für Sozīalwissenschaftler. Berlin: Springer.

    Google Scholar 

  • Brennan, A. F., Barret, C. L., & Garretson, H. D. (1986). The prediction of chronic pain outcome by psychological variables. International Journal of Psychiatry in Medicine, 16, 373.

    Google Scholar 

  • Cella, D. F. (1994). Quality of life: Concepts and definition. Journal of Pain & Symptom Management, 9, 186–192.

    Google Scholar 

  • Christensen, F. B., Nielsen, B. K., Hansen, E. S., Pilgaard, S., & Bunger, C. E. (1994). Forreste lumbal interkorporal spondylodesis. Radiologisk og funktionelt behanlingsresultat. Ugeskrift für Laeger, 156, 5285–5289.

    Google Scholar 

  • Davis, R. A. (1994). A long-term outcome analysis of 984 surgically treated herniated lumbar discs. Journal of Neurosurgery, 80, 415–421.

    Google Scholar 

  • Deen, H. G., Jr., Zimmerman, R. S., Lyons, M. K., McPhee, M. C., Verheijde, J. L., & Lemens, S. M. (1995). Measurement of exercise tolerance on the treadmill in patients with symptomatic lumbar spinal stenosis: A useful indicator of functional status and surgical outcome. Journal of Neurosurgery, 83, 27–30.

    Google Scholar 

  • Deyo, R. A., Andersson, G., Bombardier, C., Cherkin, D. C., Keller, R. B., Lee, C. K., Liang, M. H., Lipscomb, B., Shekelle, P., Spratt, K. F., et al. (1994). Outcome measures for studying patients with low back pain. Spine, 19 (Suppl. 18, 2032S–2036S.

  • Dimenas, E. S., Dahlof, C. G., Jern, S. C., & Wilkung, I. K. (1990). Defining quality of life in medicine. Scandinavian Journal of Primary Health Care, 1 (Suppl.), 7–10.

    Google Scholar 

  • Doxey, N. C., Dzioba, R. B., Mitson, G. L., & Lacroix, J. M. (1988). Predictors of outcome in back surgery candidates. Journal of Clinical Psychology, 44, 611–622.

    Google Scholar 

  • Dzioba, R. B., & Doxey, N. C. (1984). A prospective investigation into the orthopaedic and psychologic predictors of outcome of first lumbar surgery following industrial injury. Spine, 9, 614–623.

    Google Scholar 

  • Flor, H., Behle, D., & Birbaumer, N. (1993). Assessment of pain related cognitions in chronic pain patients. Behavioural Research & Therapy, 31, 63–67.

    Google Scholar 

  • Fordyce, F. E. (1976). Behavioral methods for chronic pain and illness. St. Louis: Mosby.

    Google Scholar 

  • Greenough, C.G., Taylor, L.J., & Fraser, R.D. (1994). Anterior lumbar fusion: Results, assessment techniques and prognostic factors. European Spine Journal, 3, 225–230.

    Google Scholar 

  • Gross, A. R. (1986). The effect of coping strategies on the relief of pain following surgical intervention for lower back pain. Psychosomatic Medicine, 48, 229–241.

    Google Scholar 

  • Hanley, E.N. (1995). The indications for lumbar spinal fusion with and without instrumentations. Spine, 20(Suppl.), 143S–153S.

    Google Scholar 

  • Hasenbring, M. (1992). Chronifizierung bandscheibenbedingter Schmerzen: Risikofaktoren und gesundheitsförderndes Verhalten. Stuttgart: Schattauer.

    Google Scholar 

  • Hautzinger, M., Bailer, M., Worall, H., & Keller, F. (1994). Beck-Depressions-lnventar (BDI, Bearbeitung der deutschen Ausgabe). Bern: Hans Huber.

    Google Scholar 

  • Hayry, M. (1991). Measuring the quality of life: Why, how and what? Theoretical Medicine, 12, 97–116.

    Google Scholar 

  • Herda, C. A., Wirth, T., Basler, H.D., Florin, I., & Griss, P. (1991). Prognose des Erfolges von Operationen an der Bandscheibe. Eine Untersuchung an Patienten mit Schmerzen nach einem lumbalen Bandscheibenvorfall. Der Schmerz, 5, 148–154.

    Google Scholar 

  • Herda, C. A., Bonnenberg, S., Redegeld, M., Lengsfeld, M., Florin, I., & Basler, H. D. (1993). Ein Fragebogen zu Schmerzverhalten und Verstärkungsbedingungen bei Rückenschmerzen. Diagnostica, 39, 322–328.

    Google Scholar 

  • Herron, L. D., & Turner, J. (1985). Patient selection for lumbar laminectomy and discectomy with a revised objective rating system. Clinical Orthopedics and Related Research, 19, 145.

    Google Scholar 

  • Herron, L. D., Turner, J. A., & Weiner, P. (1986). The differential utility of the Minnesota Multiphasic Personality Inventory. A predictor of outcome in lumbar laminectomy for disc herniation versus spinal stenosis. Spine, 11, 847–850.

    Google Scholar 

  • Herron, L. D., Turner, J. A., & Weiner, P. (1988a). Does the MMPI predict chemonucleolysis outcome? Spine, 13, 84–88.

    Google Scholar 

  • Herron, L. D., Turner, J. A., & Weiner, P. (1988b). Lumbar disc herniations: The predictive value of the Health Attribution Test (HAT) and the Minnesota Multiphasic Personality Inventory (MMPI). Journal of Spinal Disorders, 1, 2–8.

    Google Scholar 

  • Hoffman, L. G., Rouse, M. W., & Brin, B. N. (1995). Quality of life: A review. Journal of the American Optometric Association, 66, 281–289.

    Google Scholar 

  • Junge, A., Dvorak, J., & Ahrens, S. (1995). Predictors of bad and good outcome of lumbar disc surgery. A prospective clinical study with recommendations for screening to avoid bad outcome. Spine, 20, 460–468.

    Google Scholar 

  • Katz, J. N., Lipson, S. J., Larson, M. G., McInnes, J. M., Fossel, A. H., & Liang, M. H. (1991). The outcome of decompressive laminectomy for degenerative lumbar stenosis. Journal of Bone and Joint Surgery—American Volume, 73, 809–816.

    Google Scholar 

  • Katz, J. N., Wright, E. A., Guadagnoli, E., Liang, M. H., Karlson, E. W., & Clearly, P. D. (1994). Differences between men and women undergoing major orthopedic surgery for degenerative arthritis. Arthritis & Rheumatism, 37, 687–694.

    Google Scholar 

  • Katz, J. N., Lipson, S. J., Brick, G. W., Grobler, L. J., Weinstein, J. N., Fossel, A. H., Lew, R. A., & Liang, M. H. (1995). Clinical correlates of patient satisfaction after laminectomy for degenerative lumbar spinal stenosis. Spine, 20, 1155–1160.

    Google Scholar 

  • Keefe, F. J., Gil, K. M., & Rose, S. C. (1986). Behavioral approaches in the multidisciplinary management of pain: Programs and issues. Clinical Psychological Review, 9, 589–598.

    Google Scholar 

  • Kohlmann, T., Nuding, B., & Raspe, H. H. (1992). Funtionsbehinderung, schmerzbezogene Kognitionen und emotionale Beeinträchtigung bei Rückenschmerzen. In E. Geissner & G. Jungnitsch (Eds.), Psychologie des Schmerzes (pp. 107–118). Weinheim: Psychologie Verlags Union.

    Google Scholar 

  • Manniche, C., Asmussen, K. H., Vinterberg, H., Rose-Hansen, E. B., Kramhoft, J., & Jordan, A. (1994). Back pain, sciatica and disability following first-time conventional haemilaminectomy for lumbar disc herniation. Use of “Low Back Pain Rating Scale” as a postal questionnaire. Danish Medical Bulletin, 41, 103–106.

    Google Scholar 

  • Raspe, H. H. (1993). Back pain. In A. J. Silman & N. C. Hochberg (Eds.), Epidemiology of the rheumatic diseases (pp. 330–374). Oxford: Oxford University Press.

    Google Scholar 

  • Simmons, S. (1994). Quality of life in community mental health care—A review. International Journal of Nursing Studies, 31, 183–193.

    Google Scholar 

  • Sörensen, L. V., Mors, O., & Skovlund, O. (1987). A prospective study of the importance of psychosocial and social factors for the outcome after surgery in patients with slipped lumber disk operated upon for the first time. Acta Neurochirurgica, 88, 119.

    Google Scholar 

  • Stevens, J. (1992). Applied multivariate statistics for the social sciences. Hillsdale, NJ: Lawrence Erlbaum Associates.

    Google Scholar 

  • Tabachnik, B. G., & Fidell, L. S. (1989). Using multivariate statistics. New York: Harper Collins.

    Google Scholar 

  • Thorvaldsen, P., & Sörensen, E. B. (1989). Short-term outcome in lumbar spine surgery. A prospective study. Acta Neurochirgica (Wien), 101, 121–125.

    Google Scholar 

  • Tuite, G. F., Stern, J. D., Doran, S. E., Papadopoulos, S. M., McGillicuddy, J. E., Oyedijo, D. I., Grube, S. V., Lundquist, C., Gilmer, H. S., & Schork, M. A. (1994). Outcome after laminectomy for lumbar spinal stenosis. Part I: Clinical correlations. Journal of Neurosurgery, 81, 699–706.

    Google Scholar 

  • Turk, D. C., & Rudy, T. E. (1988). A cognitive-behavioral perspective on chronic pain: Beyond the scalpel and syringe. In C. D. Tollison (Ed.), Handbook of chronic pain management (pp. 222–236). Baltimore: Williams and Wilkins.

    Google Scholar 

  • Turner, J. A., Ersek, M., Herron, L. Haselkorn, J., Kent, D., Ciol, M. A., & Deyo, R. (1992). Patient outcomes after lumbar spinal fusions. Journal of the American Medical Association, 268, 967–911.

    Google Scholar 

  • Wiltse, L. L., & Rocchio, P. D. (1975). Preoperative psychological tests as predictors of success of chemonucleolysis in the treatment of the low-back syndrome. Journal of Bone and Joint Surgery—American Volume, 57, 478–483.

    Google Scholar 

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Basler, HD., Zimmer, C., Griss, P. et al. Predicting Quality of Life After Lumbar Spondylodesis. Journal of Clinical Psychology in Medical Settings 4, 313–326 (1997). https://doi.org/10.1023/A:1026289416363

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