Jabłońska Renata, Ślusarz Robert, Królikowska Agnieszka, Haor Beata, Antczak Anna, Szewczyk Maria
Neurological and Neurosurgical Nursing Department.
Department of Surgery Nursing, Faculty of Health Science, The Ludwik Rydygier Collegium Medicum in Bydgoszcz, The Nicolaus Copernicus University,Toruń, Bydgoszcz, Poland.
J Pain Res. 2017 Jan 4;10:89-99. doi: 10.2147/JPR.S121328. eCollection 2017.
The purpose of this study was to evaluate the effects of psychosocial factors on pain levels and depression, before and after surgical treatment, in patients with degenerative lumbar and cervical vertebral disc disease.
The study included 188 patients (98 women, 90 men) who were confirmed to have cervical or lumbar degenerative disc disease on magnetic resonance imaging, and who underwent a single microdiscectomy procedure, with no postoperative surgical complications. All patients completed two questionnaires before and after surgery - the Beck Depression Inventory scale (I-IV) and the Visual Analog Scale for pain (0-10). On hospital admission, all patients completed a social and demographic questionnaire. The first pain and depression questionnaire evaluations were performed on the day of hospital admission (n=188); the second on the day of hospital discharge, 7 days after surgery (n=188); and the third was 6 months after surgery (n=140).
Patient ages ranged from 22 to 72 years, and 140 patients had lumbar disc disease (mean age, 42.7±10.99 years) and 44 had cervical disc disease (mean age, 48.9±7.85 years). Before surgery, symptoms of depression were present in 47.3% of the patients (11.7% cervical; 35.6% lumbar), at first postoperative evaluation in 25.1% of patients (7% cervical; 18.1% lumbar), and 6 months following surgery in 31.1% of patients (7.5% cervical; 23.6% lumbar). Patients with cervical disc disease who were unemployed had the highest incidence of depression before and after surgery (=0.037). Patients with lumbar disc disease who had a primary level of education or work involving standing had the highest incidence of depression before and after surgery (=0.368).
This study highlighted the association between social and demographic factors, pain perception, and depression that may persist despite surgical treatment for degenerative vertebral disc disease.
本研究旨在评估社会心理因素对退行性腰椎和颈椎间盘疾病患者手术治疗前后疼痛程度及抑郁状况的影响。
本研究纳入了188例患者（98例女性，90例男性），这些患者经磁共振成像确诊患有颈椎或腰椎退行性椎间盘疾病，并接受了单节段显微椎间盘切除术，且术后无手术并发症。所有患者在手术前后均完成了两份问卷——贝克抑郁量表（I-IV）和视觉模拟疼痛量表（0-10）。入院时，所有患者均完成了一份社会人口学调查问卷。首次疼痛和抑郁问卷评估在入院当天进行（n = 188）；第二次在出院当天，即术后7天进行（n = 188）；第三次在术后6个月进行（n = 140）。
患者年龄在22至72岁之间，其中140例患有腰椎间盘疾病（平均年龄42.7±10.99岁），44例患有颈椎间盘疾病（平均年龄48.9±7.85岁）。术前，47.3%的患者存在抑郁症状（颈椎疾病患者中为11.7%；腰椎疾病患者中为35.6%），术后首次评估时，25.1%的患者存在抑郁症状（颈椎疾病患者中为7%；腰椎疾病患者中为18.1%），术后6个月时，31.1%的患者存在抑郁症状（颈椎疾病患者中为7.5%；腰椎疾病患者中为23.6%）。颈椎间盘疾病且失业的患者在手术前后抑郁发生率最高（P = 0.037）。腰椎间盘疾病且小学文化程度或工作需要站立的患者在手术前后抑郁发生率最高（P = 0.368）。
本研究强调了社会人口学因素、疼痛感知与抑郁之间的关联，这种关联在退行性椎间盘疾病手术治疗后可能依然存在。
