Relationships Between Patient-Reported Outcomes and Psychological Factors in Preoperative Patients with Lumbar Spinal Stenosis

There are many reports the surgery results and depression of the lumbar spinal stenosis (LSS), and preoperative evaluation of depression is regarded as important. However, not only depression but other psychological problems such as anxiety and fear may be involved in dysfunction of LSS patients. The subjects were 346 patients (211 males, 135 females) of LSS preoperation from September 2010 to March 2016, and the age was 68.8 +/- 9.8 years (mean +/- SD). The patient-reported outcomes of LSS uses Roland-Morris Disability Questionnaire (RDQ), Japanese Orthopaedic Association Back Pain Evaluation Questionnaire (JOABPEQ), Zurich Claudication Questionnaire (ZCQ), and psychological evaluation includes Self-Rating Questionnaire for Depression, The Pain Catastrophizing Scale, Pain Anxiety Symptoms Scale-20, Hospital Anxiety and Depression Scale, Brief Scale for Psychiatric Problems in Orthopaedic Patients. Spearman's rank correlation coefficient of various psychological evaluation and patient-reported outcomes was analyzed. In addition, according to the cut-off point of various psychological evaluation, it divided into the normal group and the abnormal group, and the difference of severity of patient-reported outcomes was statistically compared and examined. There was no meaningful correlation between various psychological evaluations and patient-reported outcomes of LSS patients used this time (vertical bar r vertical bar<0.4). In comparison with the normal group and the abnormal group of various psychological evaluations, there was a significant difference in RDQ, JOABPEQ lumbar spine dysfunction, social life, ZCQ pain in all psychological evaluation, dysfunction was severe in the abnormal group (P<0.05). It was found that various psychological factors are also related to the lumbar functional dysfunction considered to be an organic disability. Psychological disorders such as anxiety, depression, fear, etc. in addition to disability caused by LSS may exacerbate dysfunction of LSS patients.