Brintz Carrie E, Connors Kelly Erin, Polser Geneva, Rhoten Bethany A, Foote Pearce Michelle, Coronado Rogelio A, O'Donnell Roisin, Block Shannon, Priest Amanda, Gupta Rishabh, Whitaker Sarah T, Bruehl Stephen, Stephens Byron F, Abtahi Amir M, Schwarz Jacob, Zuckerman Scott L, French Benjamin, Archer Kristin R
Department of Anesthesiology, Vanderbilt University Medical Center, Nashville, TN, USA.
Center for Musculoskeletal Research, Vanderbilt University Medical Center, Nashville, TN, USA.
Glob Adv Integr Med Health. 2025 May 21;14:27536130251344843. doi: 10.1177/27536130251344843. eCollection 2025 Jan-Dec.
People who undergo lumbar spine surgery experience variable pain, disability, and quality of life outcomes. Mindfulness-based interventions (MBIs) are recommended for chronic low back pain and may be an effective approach for surgical patients.
Evaluate the feasibility and acceptability of a telehealth MBI following lumbar spine surgery and refine the intervention for optimal delivery.
This was a prospective, mixed-methods, single-arm cohort study with measurements preoperatively and 2 weeks and 3 months postoperatively. Participants were adults undergoing lumbar spine surgery for a degenerative condition at an academic medical center. A telehealth MBI was delivered one-on-one within 4 weeks after surgery and consisted of 8 weekly sessions modeled after Mindfulness-Based Cognitive Therapy for Chronic Pain. Outcomes were feasibility (enrollment rate, retention, session attendance, homework completion), acceptability (intervention satisfaction questionnaire and exit interview); and pre- to 3-month postoperative improvements in patient-reported disability, pain, and psychosocial factors including depression, anxiety, pain catastrophizing, kinesiophobia, self-efficacy, perceived stress, and dispositional mindfulness.
Fifteen participants who received a laminectomy (n = 3) or fusion with (n = 9)/without (n = 3) laminectomy initiated the MBI. Enrollment (35%) and retention (80%) rates were lower than hypothesized, but participants had high levels of session attendance (80% completed) and home practice (median = 95% days assigned). The MBI was perceived as highly acceptable on the satisfaction questionnaire and exit interviews. Most participants reported improvements at or above established minimal clinically important differences for disability and pain at 3 months postoperatively and improvements in most psychosocial factors. Themes from exit interviews informed future modifications to the intervention.
Delivery of an 8-session, one-on-one, telehealth MBI to patients after lumbar spine surgery is feasible and acceptable and patients perceive meaningful benefits to their surgical recovery from the MBI. Results support fully powered randomized controlled trials to determine longer-term post-surgical effects of the MBI.
接受腰椎手术的患者术后疼痛、功能障碍及生活质量各不相同。基于正念的干预措施（MBIs）被推荐用于慢性下腰痛，可能对手术患者是一种有效的方法。
评估腰椎手术后远程健康MBI的可行性和可接受性，并优化干预措施以实现最佳实施。
这是一项前瞻性、混合方法、单臂队列研究，在术前、术后2周和3个月进行测量。参与者为在一所学术医疗中心因退行性疾病接受腰椎手术的成年人。术后4周内一对一提供远程健康MBI，包括8次每周一次的课程，以慢性疼痛的基于正念的认知疗法为蓝本。结果指标为可行性（入组率、留存率、课程出席率、家庭作业完成情况）、可接受性（干预满意度问卷和出院访谈）；以及术前至术后3个月患者报告的功能障碍、疼痛和心理社会因素（包括抑郁、焦虑、疼痛灾难化、运动恐惧、自我效能感、感知压力和特质正念）的改善情况。
15名接受椎板切除术（n = 3）或融合术（有椎板切除术者n = 9/无椎板切除术者n = 3）的参与者开始了MBI。入组率（35%）和留存率（80%）低于预期，但参与者课程出席率较高（80%完成）且家庭练习情况良好（中位数 = 95%指定天数）。在满意度问卷和出院访谈中，MBI被认为具有很高的可接受性。大多数参与者报告在术后3个月时功能障碍和疼痛方面有改善，且改善程度达到或超过既定的最小临床重要差异，大多数心理社会因素也有改善。出院访谈的主题为未来干预措施的修改提供了参考。
对腰椎手术后患者提供为期8节的一对一远程健康MBI是可行且可接受的，患者认为MBI对其手术恢复有显著益处。研究结果支持开展充分有力的随机对照试验，以确定MBI的长期术后效果。
