Rogers Samantha, Manson Neil, Bigney Erin, McPhee Rory, Vandewint Amanda, Richardson Eden, El-Mughayyar Dana, Abraham Edward
Dalhousie Medicine New Brunswick, Saint John, NB, Canada.
Canada East Spine Centre, Saint John, NB, Canada.
Global Spine J. 2025 Mar;15(2):392-405. doi: 10.1177/21925682231191693. Epub 2023 Jul 28.
Prospective cohort study.
Investigate the impact of thoracolumbar surgery on patients' psychosocial profiles.
A prospective cohort study of thoracolumbar surgery patients (N = 177). Measures of interest collected at baseline and 24-months after surgery were: modified Oswestry Disability Index (mODI), Numerical Rating Scores for Back Pain (NRS-B), Leg Pain (NRS-L), Pain Catastrophizing Scale (PCS), Tampa Scale of Kinesiophobia (TSK), Chronic Pain Acceptance Questionnaire-8 (CPAQ-8), Multidimensional Scale of Perceived Social Support (MSPSS), Mental Component Summary (MCS) and patient expectations for surgery impacts on mental well-being. Cohorts were separated based on attaining meaningful change defined as either 30% improvement or minimal scores in NRS-B, NRS-L and mODI. Mixed measures ANOVAs were run (α = .05).
Patients who showed meaningful change had significant improvements in PCS, TSK and CPAQ-8 scores but not in MSPSS scores. Patients had improvement in MCS scores over 24-months follow-up, but this change was not significantly different based on attainment of meaningful change. Overall, 75.9% of patients reported their mental well-being expectations were met. Patients who did not achieve meaningful change showed no change on any psychosocial measures with only 55.9% reporting their mental well-being expectations met.
Thoracolumbar surgery results in significant improvement of psychosocial variables for patients who experienced meaningful change for pain and disability. Worsening of psychosocial health was not evident in patients who did not attain meaningful change.
前瞻性队列研究。
调查胸腰椎手术对患者心理社会状况的影响。
对胸腰椎手术患者(N = 177)进行前瞻性队列研究。在基线和术后24个月收集的相关测量指标包括:改良奥斯维斯特里功能障碍指数(mODI)、背痛数字评分量表(NRS - B)、腿痛数字评分量表(NRS - L)、疼痛灾难化量表(PCS)、坦帕运动恐惧量表(TSK)、慢性疼痛接受问卷 - 8(CPAQ - 8)、领悟社会支持多维量表(MSPSS)、心理成分总结(MCS)以及患者对手术对心理健康影响的期望。根据在NRS - B、NRS - L和mODI中达到有意义的变化(定义为改善30%或最低分数)对队列进行分组。进行混合测量方差分析(α = 0.05)。
显示有意义变化的患者在PCS、TSK和CPAQ - 8评分上有显著改善,但MSPSS评分无改善。在24个月的随访中,患者的MCS评分有所改善,但根据是否达到有意义的变化,这种变化没有显著差异。总体而言,75.9%的患者报告他们的心理健康期望得到了满足。未实现有意义变化的患者在任何心理社会测量指标上均无变化,只有55.9%的患者报告他们的心理健康期望得到了满足。
对于在疼痛和残疾方面经历有意义变化的患者,胸腰椎手术可显著改善其心理社会变量。未实现有意义变化的患者心理社会健康状况并未恶化。