Download PDF
CC BY 4.0 · Rev Bras Ortop (Sao Paulo) 2024; 59(03): e372-e377
DOI: 10.1055/s-0044-1786727
Artigo Original
Coluna

Prospective Study of the Assessment of Anxiety Symptoms after Minimally Invasive Lumbar Decompression

Article in several languages: português | English
Roberto Maretti Meves 
1   Faculdade Israelita de Ciências da Saúde Albert Einstein, São Paulo, SP, Brasil
,
Pedro Cortat Couri 
2   Hospital Israelita Albert Einstein, São Paulo, SP, Brasil
,
Eliane Antonioli 
3   Pós-Graduação em Ortopedia Multiprofissional, Hospital Israelita Albert Einstein, São Paulo, SP, Brasil
,
Albert Ofenhejm Gotfryd 
4   Treinamento de Cirurgiões de Coluna, Hospital Israelita Albert Einstein, São Paulo, SP, Brasil
› Author Affiliations Financial Support There was no financial support from public, commercial, or non-profit sources.
› Further Information
Also available at
   Permissions and Reprints

Summary

Objective To analyze associations between anxiety and postsurgical clinical outcomes in patients who underwent minimally invasive lumbar decompression surgery in addition to comparing symptoms of anxiety and depression before and after surgery.

Methods This prospective cohort study of patients who underwent minimally invasive lumbar decompression surgery. Clinical outcomes were measured before and 6 months after surgery using the Visual Analog Scale (VAS), Global Perceived Effect of Change (GPE), Hospital Anxiety and Depression Scale (HADS), and Oswestry Disability Index (ODI). Based on the presurgical anxiety score, patients were categorized into anxious and non-anxious patients, and the outcomes were compared.

Results The patients of both groups obtained similar results concerning the clinical outcomes evaluated. Preoperative HADS scores decreased significantly 6 months after surgery in both anxiety (8.70 ± 3.48 vs. 5.75 ± 3.91) and depression (6.95 ± 3.54 vs. 5.50 ± 2.99). The VAS scale for the back (-2.8 ± 3.64) and legs (-5.5 ± 3.5) showed a reduction in pain.

Conclusion Minimally invasive lumbar decompression surgery promoted clinical and functional improvement, not being affected by preoperative anxiety symptoms. Mental health indicators showed a significant reduction in symptoms 6 months after surgery.

Keywords

anxiety - depression - estenosis - minimally invasive surgical procedures - spine

Work developed at the Albert Einstein Israelite Hospital, São Paulo, SP, Brazil.




Publication History

Received: 01 August 2023

Accepted: 18 March 2024

Article published online:
22 June 2024

© 2024. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution 4.0 International License, permitting copying and reproduction so long as the original work is given appropriate credit (https://creativecommons.org/licenses/by/4.0/)

Thieme Revinter Publicações Ltda.
Rua do Matoso 170, Rio de Janeiro, RJ, CEP 20270-135, Brazil

 

  • Referências

  • 1 Casey E. Natural history of radiculopathy. Phys Med Rehabil Clin N Am 2011; 22 (01) 1-5
    CrossrefPubMedGoogle Scholar
  • 2 Foley KT, Lefkowitz MA. Advances in minimally invasive spine surgery. Clin Neurosurg 2002; 49: 499-517
    Google Scholar
  • 3 Boukebir MA, Berlin CD, Navarro-Ramirez R. et al. Ten-Step Minimally Invasive Spine Lumbar Decompression and Dural Repair Through Tubular Retractors. Oper Neurosurg (Hagerstown) 2017; 13 (02) 232-245
    CrossrefPubMedGoogle Scholar
  • 4 Ruetten S, Komp M, Merk H, Godolias G. Surgical treatment for lumbar lateral recess stenosis with the full-endoscopic interlaminar approach versus conventional microsurgical technique: a prospective, randomized, controlled study. J Neurosurg Spine 2009; 10 (05) 476-485
    CrossrefPubMedGoogle Scholar
  • 5 Phan K, Mobbs RJ. minimally invasive versus open laminectomy for lumbar stenosis: A systematic review and meta-analysis. Spine 2016; 41 (02) E91-E100
    CrossrefPubMedGoogle Scholar
  • 6 Anderson DG, Patel A, Maltenfort M. et al. Lumbar decompression using a traditional midline approach versus a tubular retractor system: comparison of patient-based clinical outcomes. Spine 2011; 36 (05) E320-E325
    CrossrefPubMedGoogle Scholar
  • 7 Hooten WM. Chronic pain and mental health disorders: Shared neural mechanisms, epidemiology, and treatment. Mayo Clin Proc 2016; 91 (07) 955-970
    CrossrefPubMedGoogle Scholar
  • 8 Harris PA, Taylor R, Thielke R, Payne J, Gonzalez N, Conde JG. Research electronic data capture (REDCap)–a metadata-driven methodology and workflow process for providing translational research informatics support. J Biomed Inform 2009; 42 (02) 377-381
    CrossrefPubMedGoogle Scholar
  • 9 Harris PA, Taylor R, Minor BL. et al; REDCap Consortium. The REDCap consortium: Building an international community of software platform partners. J Biomed Inform 2019; 95: 103208
    CrossrefPubMedGoogle Scholar
  • 10 Delgado DA, Lambert BS, Boutris N. et al. Validation of Digital Visual Analog Scale Pain Scoring With a Traditional Paper-based Visual Analog Scale in Adults. J Am Acad Orthop Surg Glob Res Rev 2018; 2 (03) e088
    PubMedGoogle Scholar
  • 11 Costa LO, Maher CG, Latimer J. et al. Clinimetric testing of three self-report outcome measures for low back pain patients in Brazil: which one is the best?. Spine 2008; 33 (22) 2459-2463
    CrossrefPubMedGoogle Scholar
  • 12 Marcolino JA, Mathias LA, Piccinini Filho L, Guaratini AA, Suzuki FM, Alli LA. Hospital Anxiety and Depression Scale: a study on the validation of the criteria and reliability on preoperative patients. Rev Bras Anestesiol 2007; 57 (01) 52-62
    PubMedGoogle Scholar
  • 13 Vigatto R, Alexandre NM, Correa Filho HR. Development of a Brazilian Portuguese version of the Oswestry Disability Index: cross-cultural adaptation, reliability, and validity. Spine 2007; 32 (04) 481-486
    CrossrefPubMedGoogle Scholar
  • 14 Zigmond AS, Snaith RP. The hospital anxiety and depression scale. Acta Psychiatr Scand 1983; 67 (06) 361-370
    CrossrefPubMedGoogle Scholar
  • 15 Lewandrowski KU, Soriano-Sánchez JA, Zhang X. et al. Regional variations in acceptance, and utilization of minimally invasive spinal surgery techniques among spine surgeons: results of a global survey. J Spine Surg 2020; 6 (Suppl. 01) S260-S274
    CrossrefPubMedGoogle Scholar
  • 16 Kim KT, Lee SH, Suk KS, Bae SC. The quantitative analysis of tissue injury markers after mini-open lumbar fusion. Spine 2006; 31 (06) 712-716
    CrossrefPubMedGoogle Scholar
  • 17 Burton AK, Balagué F, Cardon G. et al; COST B13 Working Group on Guidelines for Prevention in Low Back Pain. Chapter 2. European guidelines for prevention in low back pain : November 2004. Eur Spine J 2006; 15 (Suppl 2): S136-S168
    CrossrefPubMedGoogle Scholar
  • 18 Gotfryd AO, Valesin Filho ES, Viola DC. et al. Analysis of epidemiology, lifestyle, and psychosocial factors in patients with back pain admitted to an orthopedic emergency unit. Einstein (Sao Paulo) 2015; 13 (02) 243-248
    CrossrefPubMedGoogle Scholar
  • 19 Demyttenaere K, Heirman E. The blurred line between anxiety and depression: hesitations on comorbidity, thresholds and hierarchy. Int Rev Psychiatry 2020; 32 (5-6): 455-465
    CrossrefPubMedGoogle Scholar
  • 20 Held U, Burgstaller JM, Deforth M, Steurer J, Pichierri G, Wertli MM. Association between depression and anxiety on symptom and function after surgery for lumbar spinal stenosis. Sci Rep 2022; 12 (01) 2821
    CrossrefPubMedGoogle Scholar
  • 21 Ma XL, Zhao XW, Ma JX, Li F, Wang Y, Lu B. Effectiveness of surgery versus conservative treatment for lumbar spinal stenosis: A system review and meta-analysis of randomized controlled trials. Int J Surg 2017; 44: 329-338
    CrossrefPubMedGoogle Scholar