Depression is associated with the long-term outcome of lumbar spinal stenosis surgery: a 10-year follow-up study

BACKGROUND CONTEXT: Depression is associated with greater postoperative disability in patients with lumbar spinal stenosis (LSS). No previous studies have reported the association in a 10-year follow-up. PURPOSE: To evaluate the association between preoperative and postoperative depressive symptoms and the surgical outcome among patients with LSS in a 10-year follow-up. In addition, we examined the effects of the depressive burden on the surgical outcome. DESIGN: A prospective observational follow-up study. PATIENT SAMPLE: A total of 102 patients with LSS underwent decompressive surgery, and 72 of the original sample participated in the 10-year follow-up study. OUTCOME MEASURES: Self-report measures: the Oswestry Disability Index (ODI) and visual analog scale (VAS). METHODS: Data were collected using a questionnaire that was administered seven times during the study period. Depressive symptoms were measured with the Beck Depressive Inventory (BDI). The depressive burden was calculated by summing the preoperative and all follow-up BDI scores. Statistical analysis included cross-sectional group comparisons and linear mixed models. The authors report no conflicts of interest related to this work. RESULTS: The high depressive burden group had a poorer outcome for pain, disability, and the walking distance at the 10-year follow-up. In linear mixed models, a higher preoperative BDI score associated with higher disability. Furthermore, higher postoperative BDI scores and the depressive burden were associated with higher disability and pain in the 10-year follow-up. CONCLUSIONS: Patients with LSS with even slightly elevated depressive symptoms have an increased risk of postoperative pain and disability in a 10-year follow-up. To improve the surgical outcome among these patients, screening for depression both preoperatively and during the rehabilitation following surgery is important. (C) 2017 Elsevier Inc. All rights reserved.