Clinical and neuropsychiatric correlates of lumbar spinal surgery in older adults: results of a pilot study

Pain Manag. 2016 Nov;6(6):543-552. doi: 10.2217/pmt.16.9. Epub 2016 Apr 22.

Abstract

Aim: To improve selection of older lumbar surgical candidates, we surveyed correlates of functioning and satisfaction with surgery.

Materials & methods: Prospective sample at lumbar spine surgery clinic. Patients (n = 48) were evaluated before surgery and after 3 months. Dependent variables were functioning and surgical satisfaction.

Results: Baseline variables associated with disability at 3 months included cognitive status and widespread pain. There was clinically significant improvement with moderate effects sizes for anxiety and depression at follow-up. Patients with at least a 30% improvement in disability had better physical health-related quality of life and were less likely to report widespread pain before surgery.

Conclusion: Although preliminary, two novel potential predictors of lumbar surgery outcome include diminished cognitive functioning and widespread pain. Further study of these variables on post-surgical functioning and satisfaction may improve patient selection.

Keywords: aging; complications; lumbar spine; predictors; psychiatric; spinal stenosis.

MeSH terms

  • Aged
  • Anxiety / complications
  • Cognitive Dysfunction / complications
  • Depression / complications
  • Female
  • Humans
  • Low Back Pain / complications
  • Low Back Pain / psychology*
  • Low Back Pain / surgery*
  • Lumbosacral Region / surgery
  • Male
  • Mental Status Schedule
  • Middle Aged
  • Patient Satisfaction
  • Patient Selection*
  • Pilot Projects
  • Prospective Studies
  • Treatment Outcome