Depression Anxiety on Patient Outcomes Following Lumbar Spine Surgery

Journal of Surgery

ISSN: [Jurnalul de chirurgie]
ISSN: 1584-9341

Open Access

Commentary - (2022) Volume 18, Issue 11

Depression Anxiety on Patient Outcomes Following Lumbar Spine Surgery

David Bentrem*
*Correspondence: David Bentrem, Department of Obstetrics Surgery, Feinberg School of Medicine, Chicago, IL, USA, Email:
Department of Obstetrics Surgery, Feinberg School of Medicine, Chicago, IL, USA

Received: 02-Nov-2022, Manuscript No. jos-22-78822; Editor assigned: 04-Nov-2022, Pre QC No. P-78822; Reviewed: 18-Nov-2022, QC No. Q-78822; Revised: 24-Nov-2022, Manuscript No. R-78822; Published: 30-Nov-2022 , DOI: 10.37421/1584-9341.2022.18.64
Citation: Bentrem, David. “Depression Anxiety on Patient Outcomes Following Lumbar Spine Surgery.” J Surg 18 (2022):64.
Copyright: © 2022 Bentrem D. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.


Surgery called lumbar fusion is frequently used to treat symptomatic spinal stenosis that is also associated with instability. With about 200 000 operations carried out each year, the rate of lumbar fusions has been gradually rising over the previous ten years. Higher patient satisfaction ratings and better patient-reported outcome metrics have been linked to elective lumbar fusion for degenerative illness, particularly for spondylolisthesis .However, preoperative mental health comorbidities, such as anxiety and depression, have been linked to increased rates of complications and worse patient outcomes. There is conflicting evidence about the significance of anxiety and sadness in individuals having surgical treatment for symptomatic degenerative lumbar spinal stenosis. In patients undergoing surgery for our goal was to evaluate the relationship between symptoms and function and depression and anxiety. Patients with symptomatic DLSS who underwent surgery and finished the 24-month follow-up as part of a prospective multicentre cohort trial were included. To measure depression and anxiety, we employed the Hospital Anxiety and Depression Scale. The influence on the primary outcome change in the spinal stenosis measure symptoms/function subscale from baseline to 12- and 24-months was quantified using mixed-effects models. The likelihood that the will achieve a minimal clinically relevant difference at 24 months was calculated using logistic regression analysis [1].


An aged patient's need for spine surgery is frequently indicated by degenerative lumbar spinal stenosis. Neurogenic claudication, a pain in the gluteal area and/or lower extremities during walking that is relieved by rest and lumbar flexion can occur in symptomatic patients due to the narrowing of the spinal canal and compression of neural roots. Health-related quality of life is severely impacted by pain and functional restrictions. Treatment options for symptomatic individuals include cautious waiting, rehabilitation, painkillers, steroid and analgesic injections and decompression surgery. Approximately one-third of patients undergoing surgery will eventually not see a clinically relevant improvement, despite the fact that surgery has been proved to be effective.

About one-third of individuals with persistent back pain who are having surgery show signs of preoperative anxiety and despair. Preoperative anxiety and depression are significant outcome predictors of increased pain and physical impairments, as well as lower health-related quality of life, in patients undergoing spine surgery, according to a number of researches conducted over the past two decades. We must determine the elements that contribute to the symptoms of anxiety and sadness in order to accommodate them and, subsequently, improve surgical outcomes. To determine what causes anxiety and depressive symptoms in adult spine surgery patients while they receive treatment. These elements can be leveraged to create preoperative, postoperative educational programmes and tools to help this patient group experience less anxiety and despair. Preoperative anxiety and depressive symptoms are present in about one-third of chronic back pain patients who have surgery and have been observed to be frequent in patients with chronic back pain in general. It is estimated that patients with back pain have a two to three time’s higher prevalence of depression than the general population. Preoperative anxiety and depression are significant outcome predictors of increased pain, physical impairments and adverse outcomes, according to multiple researches conducted in the past ten years. According to the Global Burden of Disease, depression is a particularly common comorbidity that ranks third among disorders that are linked to longer lifespans and disabilities. Patients undergoing spine surgery are also disproportionately likely to experience depression. Anxiety is frequently noted in up to one-third of patients after spine surgery, along with depression. Numerous studies have shown that patients with depression or anxiety are more likely to experience adverse outcomes, such as reduced quality of life, a lengthier hospital stay, higher healthcare utilisation, increased post-operative delirium, worse ambulation, increased all-cause mortality after spine surgery and more [2].

It was decided to conduct an integrative systematic review. A more thorough understanding of a problem or phenomena is sought after by this particular scientific and validated methodology, which summarises prior empirical or theoretical literature, including qualitative, quantitative and mixed methodologies publications. The integrated approach helps to understand the complexity of previous findings and improves their capacity to guide practise and policy. Numerous medical conditions are known to cause low back pain and more recently, studies have shown that environmental and psychological factors play a part in how symptoms associated to the spine manifest. Medical organisations are becoming concerned due to the high number of patients reporting lumbar discomfort and its ensuing social and financial effects, prompting them to take into account psychosocial factors that could affect or lessen the clinical presentation. Psychological disorders, legal proceedings, one's social and professional standing and other unintended consequences are among the variables that are known to affect clinical presentation. Back discomfort has been linked to mental health conditions like depressive episodes, a diagnosis of psychosis, anxiety, restless sleep and excessive levels of stress [3].

All patients with a medical need for an instrumented lumbar interbody fusion regularly undertake a presurgical psychosocial assessment at our spine facility. The evaluation was carried out by a psychologist using a semistructured interview with each patient. The variables were: depression anxiety prior psychological/psychiatric treatment; drug or alcohol abuse; alcohol use; sleep quality; marital status; employment status; litigation; any compensation with the condition understanding of the diagnosis and treatment; suitability of coping mechanisms; and suitability of expectations. The following factors, however subjective, were regarded as red flags: prior spine surgery, worker's compensation, drug use and prior psychiatric therapy, any recompense for the disease, inadequate diagnosis and treatment knowledge. Within a person, psychological, social, labour and clinical difficulties have a close-knit and complicated link. Choosing only one psychological or social component from this group could result in an insufficient understanding of the entire issue presentation [4,5].


Because of this, a thorough psychosocial analysis should be carried out using a variety of approved techniques. Despite providing useful support, these technologies cannot replace the nature of an in-person psychiatric interview. The onset of an anxiety illness, a depressive episode, or work compensation may not be decisive on their own, but the combination of a few of these warning signs can support the diagnosis of a poor.



Conflict of Interest



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