Emotional Health Linked with Results of Low Back Pain Fusion
Many patients report ongoing pain after fusion surgery for low back pain. In this study researchers at New York Upstate Medical University identified poor emotional health as a risk factor for back and leg pain after surgery.
In a previous study, the same authors found better results in patients with lower anxiety, depression, and hostility. The lumbar fusion patients were able to return to work with less pain and more function.
In this study 160 patients had an anterior fusion with cages. The same surgeon performed all the operations. All patients were followed for at least one year. Most stayed in the study for two years. Health-related quality of life was measured before and after surgery. Pain and function were also measured.
Smoking and worker's comp were linked with poorer operative results. Scores on the mental part of tests given were also negatively linked with outcomes. Patients with poor emotional status before fusion had more pain and less function at one and two yeas after the operation.
The authors aren't sure if improving mental health before surgery will decrease pain and increase function after surgery. Future studies are suggested to look at pre-treatment to improve emotional and mental health before lumbar fusion. The authors suggest it would be better to help these patients rather than withhold surgery for fear of poor results.
Paula M. Trief, PhD, et al. Emotional Health Predicts Pain and Function After Fusion: A Prospective Multicenter Study. In Spine. April 1, 2006. Vol. 31. No. 7. Pp. 823-830.