Abstract
Background The Brief Scale for Psychiatric Problems in Orthopaedic Patients (BS-POP) is an original questionnaire that evaluates psychosocial problems in orthopaedic patients. The purpose of this study was to clarify the relationship between BS-POP scores and surgical outcomes in patients with lumbar spinal stenosis (LSS). Methods From our database, a total of 157 patients with LSS who had undergone decompression surgery and completed a 1-year follow-up were retrospectively observed. The primary outcome was the numerical rating scale (NRS) score for satisfaction with surgery (from 0: not satisfied to 10: completely satisfied). Patients with an NRS score ≥8 were classified into the satisfied group. The secondary outcomes were NRS scores for low back pain, leg pain, and leg numbness and scores on the Roland–Morris Disability Questionnaire (RDQ). BS-POP was used to detect psychiatric problems before surgery. A BS-POP score ≥11 on the physician version or a combination of 10 on the physician version and ≥15 on the patient version was considered to indicate the presence of psychiatric problems. The patients were classified into two groups and compared based on preoperative BS-POP scores at the 1-year follow-up. Results Preoperatively, 22 and 135 patients showed high and low BS-POP scores, respectively. No significant differences in preoperative symptoms were found between the two groups. At 1 year after surgery, patients with high BS-POP scores showed significantly lower satisfaction with surgery, higher NRS scores for low back pain, leg pain, and leg numbness, and lower RDQ deviation scores than did the low BS-POP group (p < 0.05). The results of the multivariable analysis indicated that preoperative high BS-POP scores were independently associated with low satisfaction with surgery (odds ratio: 5.2, 95% confidence interval: 1.9–15.1). Conclusion High preoperative BS-POP scores were associated with poor outcomes for decompression surgery in patients with LSS at 1 year after surgery. These results suggest that BS-POP is a useful tool for predicting surgical outcomes in patients with LSS.
Highlights
Psychiatric problems have been reported to be related to poor surgical outcomes in patients with lumbar spinal disorders [1]
No significant differences in numerical rating scale (NRS) scores for low back pain, leg pain, or leg numbness were observed between the two groups (Table 1)
The rate of satisfaction was significantly lower in the high BS-POP group than in the low BS-POP group (Table 2). e high BS-POP group had higher NRS scores than the low BS-POP group for low back pain, leg pain, and leg numbness (Table 2)
Summary
Psychiatric problems have been reported to be related to poor surgical outcomes in patients with lumbar spinal disorders [1]. Erefore, the value of psychiatric factors for predicting poor surgical outcomes, as well as what kind of and how many problems should be evaluated as risk factors, remains controversial for patients with lumber spinal disorders Surgeons sometimes find it difficult to treat patients with personality problems and excessive concern about their symptoms. Useful selfadministered questionnaires are available for assessing depression, including the Zung Self-Rating Depression Scale [6,7,8, 14, 17] and Beck Depression Inventory [11, 15] These tools provide substantial amounts of evidence for patients with lumbar spinal disorders, we considered that depression and other psychiatric problems, such as personality problems, are essential for the evaluation of such patients preoperatively. Validation and responsiveness studies for BSPOP have been conducted [20,21,22], and this questionnaire is routinely used in our institutional hospital to evaluate patients undergoing spinal surgery preoperatively. e purpose of this study was to clarify the relationship between preoperative BS-POP scores and lumbar surgery outcomes and the usefulness of BS-POP
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