Mild Depression May Slow Spine Surgery Recovery

Spinal stenosis operations may have better outcomes in patients with fewer depressive symptoms

/ Author:  / Reviewed by: Joseph V. Madia, MD Beth Bolt, RPh

(RxWiki News) Spinal stenosis tends to affect patients as they grow older. Surgery can provide relief, but those with even slight depression may face difficulties recovering.

Surgery for spinal stenosis can help strengthen the backbone and maintain alignment of the spine. Some patients, however, become depressed after surgery. These feelings have been shown to slow the healing process, according to the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMSD).

And new research has found that back surgery patients who have even mild depressive symptoms may have more trouble with walking, lifting, sitting and other movements than those who are not depressed.

Maarit Pakarinen, MD, with the Department of Psychiatry at Kuopio University Hospital, served as lead author of the study.

“The results indicate that attention should be paid to even mild depressive symptoms both before and after the surgery,” Dr. Pakarinen said in a press release. “This would allow health care professionals to recognize patients who might benefit from enhanced psychosocial support as part of their surgery-related treatment and rehabilitation process.”

Dr. Pakarinen and colleagues followed 102 patients who had surgery for lumbar spinal stenosis.

Spinal stenosis is a narrowing of the spaces in the backbone where nerves pass through. Numbness, weakness, cramping, or pain in the arms or legs are common symptoms. It is most common in patients older than 50, NIAMSD reports.

Patients in this study reported their mental status, feelings of pain and limits on their “functional capacity,” such as the ability to walk, lift and sit. They answered surveys on these items before and after surgery. They answered the survey at three months, one year, two years and five years after the surgery.

At the end of the follow-up period, the study authors found that 15 percent of the patients had depressive symptoms that could be categorized as at least mild depression

Subjects with depressive symptoms had less functional capacity than patients who were not depressed during the entire five years of the study, the authors found.

The study authors said that those with more signs of depression recovered from surgery more poorly than those who were not depressed. Patients received scores representing their levels of disability and depression based on survey responses.

Patients with the highest depression scores — meaning they were the most depressed — after five years also had the highest disability scores. Likewise, those with lowest depression scores had the lowest disability scores. Those with the highest ratings for depression, for instance, were only able to walk distances that were around half as far as those with the least depression.

Surgery seemed to help all the patients — no matter their level of depression. The authors noted that improvement in walking distance and disability scores among all the patients showed the overall positive effects of the surgery.

The study was published in October in The Spine Journal.

The authors disclosed no funding sources or conflicts of interest.


Review Date: 
November 3, 2014
Last Updated:
November 4, 2014