Vojnosanitetski pregled 2022 Volume 79, Issue 8, Pages: 781-788
https://doi.org/10.2298/VSP210328049P
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Pain and functional disability after lumbar microdiscectomy and their correlations with gender, depression and recovery expectations
Pantelinac Slobodan 
(University of Novi Sad, Faculty of Medicine, Novi Sad, Serbia + University Clinical Center of Vojvodina, Medical Rehabilitation Clinic, Novi Sad, Serbia), slobodan.pantelinac@mf.uns.ac.rs
Grajić Mirko (University of Belgrade, Faculty of Medicine, Belgrade, Serbia + University Clinical Center of Serbia, Center for Physical Medicine and Rehabilitation, Belgrade, Serbia)
Knežević Aleksandar (University of Novi Sad, Faculty of Medicine, Novi Sad, Serbia + University Clinical Center of Vojvodina, Medical Rehabilitation Clinic, Novi Sad, Serbia)
Nikolić Dejan (University of Belgrade, Faculty of Medicine, Belgrade, Serbia + University Children’s Hospital, Physical Medicine and Rehabilitation Department, Belgrade, Serbia)
Tomašević-Todorović Snežana (University of Novi Sad, Faculty of Medicine, Novi Sad, Serbia + University Clinical Center of Vojvodina, Medical Rehabilitation Clinic, Novi Sad, Serbia)
Background/Aim. Among the various factors that can influence continued postoperative back pain and/or leg pain, and functional disability after lumbar microdiscectomy are gender, depression, and pessimism. The aim of this study was to determine the correlations between these factors. Methods. The research was conducted after microdiscectomy on 198 patients (95 men and 103 women), with a mean age of 50.20 ± 10.26 years. The following questionnaires were used for examinations: for assessment of pain and its intensity and character – PainDETECT Test; for functional disability – Oswestry Low Back Pain Disability Questionnaire; for the presence and degree of depression – Beck Depression Inventory-II; and questionnaire for the assessment of personal expectations (pessimistic/optimistic) about the treatment results. These assessments were carried out after microdiscectomy – just before rehabilitation treatment, one month later, and then 3 and 6 months after a microdiscectomy. Results. Depression (p < 0.01) and pessimism (p < 0.01) had significant negative influences on the pain and functional disability. The subjective sensation of pain was significantly higher in women than in men (p < 0.01), while men had a greater degree of functional disability (p < 0.01) than women. Conclusion. Pain and functional disability of the patients after lumbar microdiscectomy are significantly interconnected with gender, depression, and pessimism. The sensation of pain was higher in women, while men had a greater degree of functional disability. Globally, the intensity of pain and functional disability were significantly greater in patients with a higher degree of depression and pessimism, and, by registering mentioned factors, it is possible to predict the postoperative results.
Keywords: disability evaluation, intervertebral disc displacement, lumbosacral region, neurosurgical procedures, pain, postoperative complications, postoperative period, risk factors
Show references
Rigoard P, Desai MJ, Taylor RS. Failed back surgery syndrome: what's in a name? A proposal to replace "FBSS" by "POPS"…. Neurochirurgie 2015; 61(Suppl 1): S16-21.
Daniell JR, Osti OL. Failed Back Surgery Syndrome: A Review Article. Asian Spine J 2018; 12(2): 372-9.
Bordoni B, Marelli F. Failed back surgery syndrome: review and new hypotheses. J Pain Res 2016; 9: 17-22.
Sahin N, Sargin S, Atik A. Failed Back Surgery: A Clinical Review. Int J Orthop 2015; 2(5): 399-404.
Epker J, Block AR. Psychological Screening Before Spine Surgery: Avoiding Failed Surgery Syndrome. Psychol Inj Law 2014; 7: 317-24.
Cetin A, Gokdemir TM. Evaluation of pain status and quality of life in patients with lumbar disc hernia who underwent microdiscectomy. Med Sci 2018; 7(4): 745-7.
Strøm J, Bjerrum MB, Nielsen CV, Thisted CN, Nielsen TL, Laursen M, et al. Anxiety and depression in spine surgery-a systematic integrative review. Spine J 2018; 18(7): 1272-85.
Yalbuzdag SA, Erol AM, Sengul I, Celik C, Solum S, Adilay HU, Gungor B. Temperament and Character Profile in Failed Back Surgery Syndrome: A Cross-Sectional Clinical Study. Turk Neurosurg 2016; 26(6): 912-7.
Campbell P, Hope K, Dunn KM. The pain, depression, disability pathway in those with low back pain: a moderation analysis of health locus of control. J Pain Res 2017; 10: 2331-9.
Shi J, Wang Y, Zhou F, Zhang H, Yang H. Long-term clinical outcomes in patients undergoing lumbar discectomy by fenestration. J Int Med Res 2012; 40(6): 2355-61.
Hegarty D, Shorten G. Multivariate prognostic modeling of persistent pain following lumbar discectomy. Pain Physician 2012; 15(5): 421-34.
Srivastava S, Yadav P, Panchal NB, Vala UA, Ratnani I, Khania P. Association of depression and chronic lower-back pain. Arch Psychiatr Psychother 2018; 4: 37-46.
Pinheiro MB, Ferreira ML, Refshauge K, Maher CG, Ordonana JR, Andrade TB, et al. Symptoms of depression as a prognostic factor for low back pain: a systematic review. Spine J 2016; 16(1): 105-16.
Nijs J, Apeldoorn A, Hallegraeff H, Clark J, Smeets R, Malfliet A, et al. Low Back Pain: Guidelines for the Clinical Classification of Predominant Neuropathic, Nociceptive, or Central Sensitization Pain. Pain Physician 2015; 18(3): 333-46.
Freynhagen R, Baron R, Gockel U, Tölle TR. Pain DETECT: a new screening questionnaire to identify neuropathic components in patients with back pain. Curr Med Res Opin 2006; 22(10): 1911-20.
Shamji MF, Shcharinsky A. Use of neuropathic pain questionnaires in predicting persistent postoperative neuropathic pain following lumbar discectomy for radiculopathy. J Neurosurg Spine 2016; 24(2): 256-62.
Jabłońska R, Ślusarz R, Królikowska A, Haor B, Antczak A, Szewczyk M. Depression, social factors, and pain perception before and after surgery for lumbar and cervical degenerative vertebral disc disease. J Pain Res 2017; 10: 89-99.
Löbner M, Luppa M, Matschinger H, Konnopka A, Meisel HJ, Günther L, et al. The course of depression and anxiety in patients undergoing disc surgery: a longitudinal observational study. J Psychosom Res 2012; 72(3): 185-94.
Lebow R, Parker SL, Adogwa O, Reig A, Cheng J, Bydon A, et al. Microdiscectomy improves pain-associated depression, somatic anxiety, and mental well-being in patients with herniated lumbar disc. Neurosurgery 2012; 70(2): 306-11.
Tharin S, Mayer E, Krishnaney A. Lumbar microdiscectomy and lumbar decompression improve functional outcomes and depression scores. Evid Based Spine Care J 2012; 3(4): 65-6.
Lurie DJ, Henderson RE, McDonough MC, Berven HS, Scherer AE, Tosteson DT, et al. The Effect of Expectations on Treatment Outcome for Lumbar Intervertebral Disc Herniation. Spine (Phila Pa 1976) 2016; 41(9): 803-9.
Dorow M, Löbner M, Stein J, Konnopka A, Meisel HJ, Günther L, et al. Risk Factors for Postoperative Pain Intensity in Patients Undergoing Lumbar Disc Surgery: A Systematic Review. PLoS ONE 2017; 12(1): e0170303.
Farzanegan G, Alghasi M, Safari S, Ahmadi SA. Effects of lumbar discectomy on disability and depression in patients with chronic low back pain. Anesth Pain Med 2011; 1(1): 20-4