Abstract
ABSTRACT Objective: The result of treatment of patients with degenerative disc diseases is partly determined by the psychological characteristics of the patients. The aim of this study was to examine the correlations between the psychological scales scores in patients with degenerative lumbar disc diseases and the effectiveness of surgical treatment. Methods: The efficacy of the operation and patients’ satisfaction were compared with the preoperative psychological characteristics, according to the questionnaires and scales (BBQ Symonds, Zung Scale, FABQ, PCI, BBQ Catastrophization). Results: In patients with neurogenic intermittent claudication syndrome without significant pain, the operative treatment depended significantly on the value of the BBQ Symonds scale (p = 0.016). In patients with severe radicular pain in the lower extremity, the effectiveness of the operation depended significantly on the value of the subscale “protection” of the PCI questionnaire (p = 0.04), the ODI index filled out before the operation (p = 0.0). In patients with lumbar syndrome, the effectiveness of operation depended significantly on the value of the PCI questionnaire as a whole (p = 0.042) and its subscores “rest” (p = 0.028), the index of the Oswestry filled out before the operation (p = 0.035). Conclusion: The effectiveness of the operation of degenerative lumbar disc diseases is associated with the results of preoperative psychological testing. It has been established that the BBQ Symonds scale, PCI protection and rest subscales, and the ODI questionnaire are the most significant; these psychological scales have the power to predict the effectiveness of surgical treatment. Level of Evidence II; Therapeutic Study - Investigating the Results of Treatment.
Highlights
Degenerative diseases of the spine are one of the most common groups of pathologies of the musculoskeletal system
The first group consisted of patients with neurogenic intermittent claudication without severe pain syndrome in any area
The second group consisted of patients with pronounced pain syndrome in the lower extremity due to radiculopathy caused by a herniated disc in the lumbar spine
Summary
Degenerative diseases of the spine are one of the most common groups of pathologies of the musculoskeletal system Their prevalence in the general population is around 25% and increases to 45% in individuals over 60 years of age.[1,2] This nosology is characterized by chronic pain in the back or leg, and is often accompanied by persistent disability. Even though spinal interventions have demonstrated surgical efficacy, the clinical outcomes of the surgeries range from 35 to 75% improvement, depending on the type of surgery perfomed performed,[3,4,5,6,7] with up to 23% incidence of repeated surgeries.[8] Up to 40% of patients note that the pain continues after the surgical treatment, albeit with lower intensity.[9,10,11] These results indicate that the efficiency of treatment of patients with degenerative diseases of the spine is determined solely by the completeness of surgical treatment. There is increasing evidence that the observed variability in outcomes of spinal surgeries may be partially attributed to the preoperative psychological characteristics of patients in their study Adogwa and Carr et al[12] demostrated demonstrated that preoperative screening of psychological status enables the identification of patients at risk of unfavorable outcomes of surgery; the baseline level of psychological predisposition was useful in predicting poor clinical outcomes after surgery
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