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Responsiveness of depression and its influence on surgical outcomes of lumbar degenerative diseases

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European Journal of Orthopaedic Surgery & Traumatology Aims and scope Submit manuscript

Abstract

Objective

To demonstrate the responsiveness of depression after surgery for lumbar degenerative disease and to verify the impact of this condition on surgical outcomes.

Patient sample

A prospective cohort study with 91 patients with lumbar degenerative diseases who were evaluated preoperatively, at 30 days and 1 year postoperatively.

Outcome measures

Evolution of depression between the follow-ups and its correlation with satisfaction.

Methods

Depression was assessed with Beck Depression Inventory. According to depression responsiveness, patients were classified into four groups: NN = no depression; ND = normal during the preoperative period and depression within 1 year; DN = depression during the preoperative period and normal within 1 year; DD = depression during the preoperative period and within 1 year.

Results

Prevalence of preoperative depression was 28.6 % and 17.6 % within 1 year postoperatively. Most patients (65.4 %) with depression in the preoperative period recovered postoperatively. Poor preoperative HRQoL measures were associated with higher rates of responsiveness of depression during the follow-up. Patients with depression at the 1-year postoperative follow-up had a worse functional outcome. Patients who improved from depression had similar outcome to those without depression. Dissatisfaction within 1 year postoperatively was greater in patients who become depressed after surgery and remain depressed at 1-year follow-up (NN = 8.8 %; ND = 42.9 %; DN = 17.6 %; DD = 44.4 %; P = 0.012).

Conclusion

Most patients with depression in the preoperative recover within 1 year postoperatively. Responsiveness of depression is associated with surgical outcomes. The presence of depression after the surgical treatment, independent of when it starts, had a major negative impact on prognosis.

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Conflict of interest

The author(s) has/have received or will receive benefits for personal or professional use from a commercial party related directly or indirectly to the subject of this manuscript. These benefits have been or will be directed to a research fund, foundation, educational institution, or other nonprofit organization with which one or more of the author(s) is/are associated.

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Authors and Affiliations

  1. Department of Neurosurgery, University of Caxias do Sul, Rua General Arcy da Rocha Nóbrega, 401/602, Caxias do Sul, RS, CEP: 95040-290, Brazil

    Asdrubal Falavigna

  2. Laboratory of Clinical Studies and Basic Models of Spinal Disorders, University of Caxias do Sul, Caxias do Sul, RS, Brazil

    Asdrubal Falavigna, Orlando Righesso, Lucas Piccoli Conzati, Julia Bertholdo Bossardi & Pedro Guarise da Silva

  3. Neurosurgery Unit, Hospital São José, Santa Casa de Porto Alegre, Porto Alegre, RS, Brazil

    Alisson Roberto Teles

  4. Department of Neurosurgery, Vanderbilt University School of Medicine, Nashville, TN, USA

    Joseph S. Cheng

Authors
  1. Asdrubal Falavigna
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  2. Orlando Righesso
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  3. Alisson Roberto Teles
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  4. Lucas Piccoli Conzati
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  5. Julia Bertholdo Bossardi
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  6. Pedro Guarise da Silva
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  7. Joseph S. Cheng
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Correspondence to Asdrubal Falavigna.

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Falavigna, A., Righesso, O., Teles, A.R. et al. Responsiveness of depression and its influence on surgical outcomes of lumbar degenerative diseases. Eur J Orthop Surg Traumatol 25 (Suppl 1), 35–41 (2015). https://doi.org/10.1007/s00590-015-1651-0

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  • DOI: https://doi.org/10.1007/s00590-015-1651-0

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