Prospective Study of the Assessment of Anxiety Symptoms after Minimally Invasive Lumbar Decompression

Meves, Roberto Maretti; Couri, Pedro Cortat; Antonioli, Eliane; Gotfryd, Albert Ofenhejm

doi:10.1055/s-0044-1786727

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Revista Brasileira de Ortopedia

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Sumário

Original Article • Rev bras ortop 59 (3) • 2024 • https://doi.org/10.1055/s-0044-1786727 copy

Prospective Study of the Assessment of Anxiety Symptoms after Minimally Invasive Lumbar Decompression

Authorship SCIMAGO INSTITUTIONS RANKINGS

Summary

Objective

To analyze associations between anxiety and postsurgical clinical outcomes in patients who underwent minimally invasive lumbar decompression surgery in addition to comparing symptoms of anxiety and depression before and after surgery.

Methods

This prospective cohort study of patients who underwent minimally invasive lumbar decompression surgery. Clinical outcomes were measured before and 6 months after surgery using the Visual Analog Scale (VAS), Global Perceived Effect of Change (GPE), Hospital Anxiety and Depression Scale (HADS), and Oswestry Disability Index (ODI). Based on the presurgical anxiety score, patients were categorized into anxious and non-anxious patients, and the outcomes were compared.

Results

The patients of both groups obtained similar results concerning the clinical outcomes evaluated. Preoperative HADS scores decreased significantly 6 months after surgery in both anxiety (8.70 ± 3.48 vs. 5.75 ± 3.91) and depression (6.95 ± 3.54 vs. 5.50 ± 2.99). The VAS scale for the back (-2.8 ± 3.64) and legs (-5.5 ± 3.5) showed a reduction in pain.

Conclusion

Minimally invasive lumbar decompression surgery promoted clinical and functional improvement, not being affected by preoperative anxiety symptoms. Mental health indicators showed a significant reduction in symptoms 6 months after surgery.

Keywords
anxiety; depression; estenosis; minimally invasive surgical procedures; spine

			Group
		All	Non-anxious	Anxious
		(n = 44)	(n = 20)	(n = 24)
Gender
	Male (%)	22	12	10
	Female (%)	22	8	14
Schooling
	Undergraduate degree	33	17	16
	Unfinished undergraduate degree	4	0	4
	High school degree	5	2	3
	Middle school degree	1	0	1
	Technical degree	1	1	0
	Age	42.5 ± 10.4	45.6 ± 10.4	39.9 ± 9.76
	BMI (Kg/m2)	27.1 ± 3.8	26.8 ± 3.52	27.3 ± 4.09
	Height (m)	1.7 ± 0.1	1.71 ± 9.13	1.71 ± 12.1
	Weight (Kg)	79.4 ± 14.4	79.3 ± 16	79.6 ± 13.2


	Non-anxious	Anxious	p	Non-anxious	Anxious	p	Non-anxious	Anxious
HADS
Anxiety	5.65±2.06	11.3±2.07	<0.001^*	3.9 (±3.42)	7.29 (±3.66)	0.003	-1.75 (±3.61)	-3.96 (±3.84)
Depression	4.7±2.13	8.83±3.41	<0.001^*	4.1 (±1.83)	6.67 (±3.29)	0.003	-0.6 (±2.76)	-2.17 (±3.06)
VAS
Back	4.6±3.22	5.92±2.7	0.16	2.45 (±3.22)	2.58 (±2.41)	0.562	-2.15 (±3.9)	-3.33 (±3.41)
Legs	6.6±2.89	7.72±2.4	0.44	1.8 (±2.78)	1.62 (±2.24)	0.919	-4.8 (±4.21)	-6.08 (±2.73)
GPE	-0.6±3.55	-0.38±3.51	0.73	2.6 (±2.89)	2.33 (±2.56)	0.457	3.2 (±5.4)	2.71 (±4.36)
ODI	36.5±20.8	52.8±22.9	0.02^*	10.4 (±10.4)	13.8 (±10.9)	0.29	-26.1 (±21.4)	-37.9 (±21.9)

		Preoperative	6 months after surgery
				p
HADS
	Anxiety	8.7 (±3.48)	5.91 (±4.01)	< 0.001
	Depression	6.95 (±3.54)	5.6 (±3.03)	0.005
VAS
	Back	5.32 (±3.03)	2.52 (±2.70)	< 0.001
	Legs	7.2 (±2.66)	1.70 (±2.47)	< 0.001
GPE		-0.48 (±3.48)	2.45 (±2.69)	< 0.001
ODI		45.4 (±23.2)	12.2 (±10.70)	< 0.001

Sociedade Brasileira de Ortopedia e Traumatologia Al. Lorena, 427 14º andar, 01424-000 São Paulo - SP - Brasil, Tel.: 55 11 2137-5400 - São Paulo - SP - Brazil
E-mail: rbo@sbot.org.br

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[1] Address for correspondence Roberto Maretti Meves, Av. Portugal, 1048, 04559-002, São Paulo, SP, Brazil (e-mail: robertommmeves@gmail.com).