Institute of Internal Medicine, Catholic University of Rome, Rome, Italy.
Neurosurgery. 2010 Aug;67(2):265-71. doi: 10.1227/01.NEU.0000371971.51755.1C.
To evaluate anxiety and depression as prognostic factors for radicular and back pain after surgery in patients with lumbar disc herniation in a 1-year follow-up study.
A total of 108 patients with lumbar disc herniation were enrolled in the study. Anxiety was assessed by State and Trait Anxiety Inventory; current depression was assessed by Zung Self-Rating Depression Scale. Severity of pain was scored on the visual analog scale (VAS). The State and Trait Anxiety Inventory, Zung Self-Rating Depression Scale, and VAS were administered before surgery and 1, 3, 6, and 12 months after surgery.
Before surgery, 72.2% of patients showed state anxiety, 54.6% of patients showed trait anxiety, and 11.1% of patients showed current depression. During the follow-up period, there was a significant decrease in the prevalence of state anxiety (P < .0001), no variation in the prevalence of trait anxiety (P = .115), and a significant increase in the prevalence of current depression (P = .002). Linear regression analysis showed that the presence of trait anxiety before surgery was the main determinant of the presence of pain after surgery (P < .0001). VAS scores were evaluated by dividing patients into 2 groups based on the presence or absence of trait anxiety before surgery. The subgroup affected by trait anxiety before surgery had significantly higher VAS scores at each follow-up assessment compared with patients without trait anxiety (P < .0001).
The presence of trait anxiety before surgery is a prognostic factor for the persistence of pain after surgery.
在一项为期 1 年的随访研究中，评估焦虑和抑郁作为腰椎间盘突出症患者术后神经根痛和腰痛的预后因素。
共纳入 108 例腰椎间盘突出症患者。采用状态特质焦虑量表评估焦虑；采用zung 自评抑郁量表评估当前抑郁。疼痛严重程度采用视觉模拟评分（VAS）评分。在手术前和手术后 1、3、6 和 12 个月，对状态特质焦虑量表、zung 自评抑郁量表和 VAS 进行评估。
手术前，72.2%的患者出现状态焦虑，54.6%的患者出现特质焦虑，11.1%的患者出现当前抑郁。在随访期间，状态焦虑的患病率显著下降（P<0.0001），特质焦虑的患病率无变化（P=0.115），当前抑郁的患病率显著增加（P=0.002）。线性回归分析表明，手术前特质焦虑的存在是术后疼痛存在的主要决定因素（P<0.0001）。根据手术前是否存在特质焦虑，将患者分为 2 组，评估 VAS 评分。手术前受特质焦虑影响的亚组在每次随访评估时的 VAS 评分均显著高于无特质焦虑的患者（P<0.0001）。
手术前特质焦虑的存在是术后疼痛持续存在的预后因素。
