Социодемографические и клинико-психологические факторы послеоперационного восстановления пациентов со стенозом позвоночного канала: обзор исследований

Обзор посвящен роли психологических факторов в восстановлении пациентов после операции на позвоночнике (при стенозе позвоночного канала). Отмечена высокая эпидемиологическая и экономическая значимость синдрома боли в спине. Приведены результаты исследований социодемографических, клинических и психологических факторов оценки пациентами удовлетворенности результатом проведенной операции и качества жизни после нее. Представлены исследования эффективности методов психологической помощи в предоперационном периоде и их влияние на восстановление после операции. Делается вывод об определенной противоречивости существующих данных, необходимости дальнейших исследований и целесообразности психологической диагностики перед операцией для уточнения прогноза восстановления после нее, выявления мишеней психологической помощи и проведения курса психологической подготовки для улучшения результатов операционного вмешательства.

1. Hoy D, March L, Brooks P, Blyth F, Woolf A, Bain C, et al. The global burden of low back pain: estimates from the Global Burden of Disease 2010 study. Ann Rheum Dis. 2014;73(6):968–974. PMID: 24665116 https://doi.org/10.1136/annrheumdis-2013-204428

2. Абакиров М.Д., Загородний Н.В., Доценко В.В. Хирургическое лечение дегенеративных стенозов поясничного отдела позвоночника. Медицина Кыргызстана. 2011;(4):56–57.

3. Kalichman L, Cole R, Kim DH, Li L, Suri P, Guermazi A, et al. Spinal stenosis prevalence and association with symptoms: the Framingham Study. Spine J. 2009;9(7):545–550. PMID: 19398386 https://doi. org/10.1016/j.spinee.2009.03.005

4. Генов П.П. Профилактика и лечение болевого синдрома в периоперационном периоде у больных с травмами и заболеваниями позвоночника: автореферат …д-ра мед. наук. Москва; 2019. URL: https://new. med.ru/sites/default/files/docs/Avtoref_Genov.pdf [Дата обращения 22.11.2022]

5. Rönnberg K, Lind B, Zoëga B, Halldin K, Gellerstedt M, Brisby H. Patients’ satisfaction with provided care/information and expectations on clinical outcome after lumbar disc herniation surgery. Spine (Phila Pa 1976). 2007;32(2):256–261. PMID: 17224823 https://doi.org/10.1097/01. brs.0000251876.98496.52

6. Thomson S. Failed back surgery syndrome – definition, epidemiology and demographics. Br J Pain. 2013;7(1):56–59. PMID: 26516498 https:// doi.org/10.1177/2049463713479096

7. Никитин А.С. Синдром оперированного позвоночника. Журнал неврологии и психиатрии им. С.С. Корсакова. 2016;116(5):112–118. https://doi.org/10.17116/jnevro201611651112-118

8. Pincus T, Kent P, Bronfort G, Loisel P, Pransky G, Hartvigsen J. TwentyFive Years with the Biopsychosocial Model of Low Back Pain – Is It Time to Celebrate? A Report from the Twelfth International Forum for Primary Care Research on Low Back Pain. Spine (Phila Pa 1976). 2013;38(24):2118–2123. PMID: 23970112 https://doi.org/10.1097/ BRS.0b013e3182a8c5d6

9. Deyo RA, Dworkin SF, Amtmann D, Andersson G, Borenstein D, Carragee E, et al. Focus article: report of the NIH Task Force on Research Standards for Chronic Low Back Pain. Eur Spine J. 2014;23(10):2028– 2045. https://doi.org/10.1007/s00586-014-3540-3

10. Laxton A, Perrin R. The relations between social support, life stress, and quality of life following spinal decompression surgery. Spinal Cord. 2003;41(10):553–558. PMID: 14504612 https://doi.org/10.1038/ sj.sc.3101432

11. Lall M, Restrepo E. The Biopsychosocial Model of Low Back Pain and Patient-Centered Outcomes Following Lumbar Fusion. Orthop Nurs. 2017;36(3):213–221. PMID: 28538537 https://doi.org/10.1097/ NOR.0000000000000350

12. Pakarinen M, Vanhanen S, Sinikallio S, Aalto T, Lehto SM, Airaksinen O, et al. Depressive burden is associated with a poorer surgical outcome among lumbar spinal stenosis patients: a 5-year follow-up study. Spine J. 2014;14(10):2392-2396. PMID: 24486473 https://doi. org/10.1016/j.spinee.2014.01.047

13. Kim H, Lee J, Kang K, Chang BS, Lee CK, Ruscheweyh R, et al. Influence of pain sensitivity on surgical outcomes after lumbar spine surgery in patients with lumbar spinal stenosis. Spine (Phila Pa 1976). 2015;40(3):193–200. PMID: 25384051 https://doi.org/10.1097/ BRS.0000000000000699

14. Dobran M, Nasi D, Gladi M, Marinelli M, Mancini F, Iacoangeli M, et al. Clinical and psychological outcome after surgery for lumbar spinal stenosis: A prospective observational study with analysis of prognostic factors. Neurol Neurochir Pol. 2018;52(1):70–74. PMID: 29246564 https://doi.org/10.1016/j.pjnns.2017.12.002

15. Schmidt S, Franke J, Rauschmann M, Adelt D, Bonsanto MM, Sola S. Prospective, randomized, multicenter study with 2-year follow-up to compare the performance of decompression with and without interlaminar stabilization. J Neurosurg Spine. 2018;28(4):406–415. PMID: 29372860 https://doi.org/10.3171/2017.11.SPINE17643

16. Kim H, Suh B, Lee D, Park JY, Kang KT, Chang BS, et al. Gender difference of symptom severity in lumbar spinal stenosis: role of pain sensitivity. Pain Physician. 2013;16(6):E715–E723. PMID: 24284852

17. Cobo Soriano J, Sendino Revuelta M, Fabregate Fuente M, Cimarra Díaz I, Martínez Ureña P, Deglané Meneses R. Predictors of outcome after decompressive lumbar surgery and instrumented posterolateral fusion. Eur Spine J. 2010;19(11):1841–1848. PMID: 20135333 https:// doi.org/10.1007/s00586-010-1284-2

18. Peteler R, Schmitz P, Loher M, Jansen P, Grifka J, Benditz A. SexDependent Differences in Symptom-Related Disability Due to Lumbar Spinal Stenosis. J Pain Res. 2021;14:747–755. PMID: 33758537 https:// doi.org/10.2147/JPR.S294524

19. Lee J, Kim H, Shim K, Park YS. The Effect of Anxiety, Depression, and Optimism on Postoperative Satisfaction and Clinical Outcomes in Lumbar Spinal Stenosis and Degenerative Spondylolisthesis Patients: Cohort Study. Clin Orthop Surg. 2017;9(2):177–183. PMID: 28567219 https://doi.org/10.4055/cios.2017.9.2.177

20. Knafo S, Apra C, Eloy G, Guigui P, Bouyer B. Fear Avoidance Beliefs and Outcome After Surgery for Degenerative Lumbar Spine. Clin Spine Surg. 2021;34(5):E271–275. https://doi.org/10.1097/BSD.0000000000001183

21. Asher A, Chotai S, Devin C, Speroff T, Harrell FE Jr, Nian H, et al. Inadequacy of 3-month Oswestry Disability Index outcome for assessing individual longer-term patient experience after lumbar spine surgery. J Neurosurg Spine. 2016;25(2):170–180. PMID: 26989974 https://doi. org/10.3171/2015.11.SPINE15872

22. Trief PM, Grant W, Fredrickson B. A prospective study of psychological predictors of lumbar surgery outcome. Spine (Phila Pa 1976). 2000;25(20):2616–2621. PMID: 11034646 https://doi. org/10.1097/00007632-200010150-00012

23. Dersh J, Gatchel RJ, Polatin P. Chronic spinal disorders and psychopathology. Research findings and theoretical considerations. Spine J. 2001;1(2):88–94. PMID: 14588387 https://doi.org/10.1016/ s1529-9430(01)00017-1

24. Kitano C, Kawakami M, Fukui D, Ishimoto Y, Nagata K, Yamada H, et al. Preoperative psychological factors affecting surgical satisfaction of elderly patients with lumbar spinal stenosis. J Orthop Sci. 2020;25(5):751– 756. PMID: 31806423 https://doi.org/10.1016/j.jos.2019.10.005

25. Gil J, Goodman A, Mulcahey M. Psychological Factors Affecting Outcomes After Elective Shoulder Surgery. J Am Acad Orthop Surg. 2018;26(5):e98–e104. PMID: 29389727 https://doi.org/10.5435/JAAOSD-16-00827

26. Adogwa O, Parker SL, Shau DN, Mendenhall SK, Aaronson OS, Cheng JS, et al. Preoperative Zung Depression Scale predicts outcome after revision lumbar surgery for adjacent segment disease, recurrent stenosis, and pseudarthrosis. Spine J. 2012;12(3):179–185. https://doi. org/10.1016/j.spinee.2011.08.014

27. McKillop AB, Carroll LJ, Battié MC. Depression as a prognostic factor of lumbar spinal stenosis: a systematic review. Spine J. 2014;14(5):837– 846. PMID: 24417814 https://doi.org/10.1016/j.spinee.2013.09.052

28. Ghoneim MM, O’Hara MW. Depression and postoperative complications: an overview. BMC Surg. 2016;16:5. PMID: 26830195 https://doi. org/10.1186/s12893-016-0120-y

29. Sinikallio S, Airaksinen O, Aalto T, Lehto SM, Kröger H, Viinamäki H. Coexistence of pain and depression predicts poor 2-year surgery outcome among lumbar spinal stenosis patients. Nord J Psychiatry. 2010;64(6):391–396. PMID: 20504268 https://doi.org/10.3109/0803948 1003759193

30. Siempis T, Prassas A, Alexiou G, Voulgaris S, Tsitsopoulos P. A systematic review on the prevalence of preoperative and postoperative depression in lumbar fusion. J Clin Neurosci. 2022;104:91–95. PMID: 35987119 https://doi.org/10.1016/j.jocn.2022.08.001

31. Chen Z, Luo R, Yang Y, Xiang Z. The prevalence of depression in degenerative spine disease patients: A systematic review and metaanalysis. Eur Spine J. 2021;30(12):3417–3427. PMID: 34476597 https:// doi.org/10.1007/s00586-021-06977-z

32. Tuomainen I, Pakarinen M, Aalto T, Sinikallio S, Kröger H, Viinamäki H, et al. Depression is associated with the long-term outcome of lumbar spinal stenosis surgery: a 10-year follow-up study. Spine J. 2018;18(3):458– 463. PMID: 28822826 https://doi.org/10.1016/j.spinee.2017.08.228

33. Vialle E, de Oliveira Pinto B, Vialle L, Gomez J. Evaluation of psychosomatic distress and its influence in the outcomes of lumbar fusion procedures for degenerative disorders of the spine. Eur J Orthop Surg Traumatol. 2015;25(Suppl 1):S25–S28. PMID: 25947933 https:// doi.org/10.1007/s00590-015-1641-2

34. Kim E, Chotai S, Stonko D, Wick JB, Schneider BJ, McGirt MJ, et al. Patient-reported outcomes after lumbar epidural steroid injection for degenerative spine disease in depressed versus non-depressed patients. Spine J. 2017;17(4):511–517. PMID: 27777051 https://doi.org/10.1016/ j.spinee.2016.10.017 35. Bufalino C, Hepgul N, Aguglia E, Pariante C. The role of immune genes in the association between depression and inflammation: a review of recent clinical studies. Brain Behav Immun. 2013;31:31–47. PMID: 22580182 https://doi.org/10.1016/j.bbi.2012.04.009

35. Obata H. Analgesic Mechanisms of Antidepressants for Neuropathic. Pain Int J Mol Sci. 2017;18(11):2483. PMID: 29160850 https://doi. org/10.3390/ijms18112483

36. Löbner M, Luppa M, Matschinger H, Konnopka A, Meisel HJ, Günther L, et al. The course of depression and anxiety in patients undergoing disc surgery: a longitudinal observational study. J Psychosom Res. 2012;72(3):185–194. PMID: 22325697 https://doi.org/10.1016/ j.jpsychores.2011.10.007

37. Sinikallio S, Aalto T, Airaksinen O, Lehto S, Kröger H, Viinamäki H. Depression is associated with a poorer outcome of lumbar spinal stenosis surgery: a two-year prospective follow-up study. Spine (Phila Pa 1976). 2011;36(8):677–682. PMID: 21037530 https://doi.org/10.1097/ BRS.0b013e3181dcaf4a

38. Carreon L, Jespersen A, Støttrup C, Hansen K, Andersen M. Is the Hospital Anxiety and Depression Scale Associated with Outcomes After Lumbar Spine Surgery? Global Spine J. 2020;10(3):266–271. PMID: 32313791 https://doi.org/10.1177/2192568219845662

39. Lee J, Park Y, Ha K, Cho S, Bak G, Kim K. Preoperative anxiety about spinal surgery under general anesthesia. Eur Spine J. 2016;25(3):698– 707. PMID: 25670066 https://doi.org/10.1007/s00586-015-3788-2

40. Archer KR, Motzny N, Abraham CM, Yaffe D, Seebach CL, Devin CJ, et al. Cognitive-behavioral-based physical therapy to improve surgical spine outcomes: a case series. Phys Ther. 2013;93(8):1130–1139. PMID: 23599351 https://doi.org/10.2522/ptj.20120426

41. Archer K, Seebach C, Mathis S, Riley L 3rd, Wegener S. Early postoperative fear of movement predicts pain, disability, and physical health six months after spinal surgery for degenerative conditions. Spine J. 2014;14(5):759–767. PMID: 24211099 https://doi.org/10.1016/ j.spinee.2013.06.087

42. Higuchi D. Adaptive and maladaptive coping strategies in older adults with chronic pain after lumbar surgery. Int J Rehabil Res. 2020;43(2):116– 122. PMID: 31842023 https://doi.org/10.1097/MRR.0000000000000389

43. Alodaibi FA, Fritz JM, Thackeray A, Koppenhaver SL, Hebert JJ. The Fear Avoidance Model predicts short-term pain and disability following lumbar disc surgery. PLoS One. 2018;13(3):e0193566. PMID: 29505603 https://doi.org/10.1371/journal.pone.0193566

44. Yamamoto Y, Kawakami M, Minetama M, Nakagawa M, Teraguchi M, Kagotani R, et al. Psychological Predictors of Satisfaction after Lumbar Surgery for Lumbar Spinal Stenosis. Asian Spine J. 2022;16(2):270–278. PMID: 34015209 https://doi.org/10.31616/asj.2020.0402

45. Wada T, Tanishima S, Kitsuda Y, Osaki M, Nagashima H, Hagino H. Association between preoperative low muscle mass and psychological factors after surgery among patients with lumbar spinal stenosis: A longitudinal study. J Clin Neurosci. 2021;89:8–14. PMID: 34119299 https://doi.org/10.1016/j.jocn.2021.04.008

46. Havakeshian S, Mannion A. Negative beliefs and psychological disturbance in spine surgery patients: a cause or consequence of a poor treatment outcome. Eur Spine J. 2013;22(12):2827–2835. PMID: 23695229 https://doi.org/10.1007/s00586-013-2822-5

47. Knechtle D, Schmid S, Suter M, Riner F, Moschini G, Senteler M, et al. Fear-avoidance beliefs are associated with reduced lumbar spine flexion during object lifting in pain-free adults. Pain. 2021;162(6):1621–1631. PMID: 33323888 https://doi.org/10.1097/j.pain.0000000000002170

48. Burgstaller J, Wertli M, Steurer J, Kessels AGH, Held U, Gramke HF. The Influence of Pre- and Postoperative Fear Avoidance Beliefs on Postoperative Pain and Disability in Patients with Lumbar Spinal Stenosis: Analysis of the Lumbar Spinal Outcome Study (LSOS) Data. Spine (Phila Pa 1976). 2017;42(7):E425–E432. PMID: 27509192 https:// doi.org/10.1097/BRS.0000000000001845

49. Quack V, Boecker M, Mueller CA, Mainz V, Geiger M, Heinemann AW, et al. Psychological factors outmatched morphological markers in predicting limitations in activities of daily living and participation in patients with lumbar stenosis. BMC Musculoskelet Disord. 2019;20(1):557. PMID: 31759398 https://doi.org/10.1186/s12891-019-2918-0

50. Teo J, Zheng Z, Bird S. Identifying the factors affecting ‘patient engagement’ in exercise rehabilitation. BMC Sports Sci Med Rehabil. 2022;14(1):18. PMID: 35130940 https://doi.org/110.1186/s13102-02200407-3

51. Geyh S, Peter C, Müller R, Bickenbach JE, Kostanjsek N, Ustün BT, et al. The Personal Factors of the International Classification of Functioning, Disability and Health in the literature – a systematic review and content analysis. Disabil Rehabil. 2011;33(13–14):1089–1102. PMID: 20925452 https://doi.org/10.3109/09638288.2010.523104

52. Coronado RA, Robinette PE, Henry AL, Pennings JS, Haug CM, Skolasky RL, et al. Bouncing back after lumbar spine surgery: early postoperative resilience is associated with 12-month physical function, pain interference, social participation, and disability. Spine J. 2021;21(1):55–63. PMID: 32736036 https://doi.org/10.1016/ j.spinee.2020.07.013E

53. Edwards RR, Dworkin RH, Sullivan MD, Turk DC, Wasan AD. The Role of Psychosocial Processes in the Development and Maintenance of Chronic Pain. J Pain. 2016;17(9 Suppl):T70–T92. PMID: 27586832 https://doi.org/10.1016/j.jpain.2016.01.001

54. Sinikallio S, Pakarinen M, Tuomainen I, Airaksinen O, Viinamäki H, Aalto TJ. Preoperative sense of coherence associated with the 10year outcomes of lumbar spinal stenosis surgery. J Health Psychol. 2019;24(7):989–997. PMID: 28810389 https://doi.org/10.1177/1359105 316687633

55. Block A. Demoralization, Patient Activation, and the Outcome of Spine Surgery. Healthcare (Basel). 2016;4(1):11. PMID: 27417599 https://doi. org/10.3390/healthcare4010011

56. Peterson S, Mesa A, Halpert B, Bordenave L. How people with lumbar spinal stenosis make decisions about treatment: A qualitative study using the Health Belief Model. Musculoskelet Sci Pract. 2021;54:102383. PMID: 33965775 https://doi.org/10.1016/j.msksp.2021.102383

57. Brembo EA, Kapstad H, Van Dulmen S, Eide H. Role of self-efficacy and social support in short-term recovery after total hip replacement: a prospective cohort study. Health Qual Life Outcomes. 2017;15(1):68. PMID: 28399883 https://doi.org/10.1186/s12955-017-0649-1

58. Knutsson B, Jong M, Sayed-Noor A, Sjödén G, Augutis M. Waiting for lumbar spinal stenosis surgery: suffering and a possibility to discover coping abilities. Orthop Rev. 2021;14(1):30716. PMID: 35106129 https:// doi.org/10.52965/001c.30716

59. Burgess L, Arundel J, Wainwright T. The Effect of Preoperative Education on Psychological, Clinical and Economic Outcomes in Elective Spinal Surgery: A Systematic Review. Healthcare (Basel). 2019;7(1):48. PMID: 30901875 https://doi.org/10.3390/healthcare7010048

60. Strøm J, Bjerrum MB, Nielsen CV, Thisted CN, Nielsen TL, Laursen M, et al. Anxiety and depression in spine surgery – a systematic integrative review. Spine J. 2018;18(7):1272–1285. PMID: 29649613 https://doi. org/10.1016/j.spinee.2018.03.017

61. Kesänen J, Leino-Kilpi H, Lund T, Montin L, Puukka P, Valkeapää K. Increased preoperative knowledge reduces surgery-related anxiety: a randomised clinical trial in 100 spinal stenosis patients. Eur Spine J. 2017;26(10):2520–2528. PMID: 28138781 https://doi.org/10.1007/ s00586-017-4963-4

62. Rolving N, Nielsen C, Christensen F, Holm R, Bünger C, Oestergaard L. Does a preoperative cognitive-behavioral intervention affect disability, pain behavior, pain, and return to work the first year after lumbar spinal fusion surgery? Spine (Phila Pa 1976). 2015;40(9):593–600. PMID: 25705964 https://doi.org/10.1097/BRS.0000000000000843

63. Archer K, Devin C, Vanston S, Koyama T, Phillips SE, Mathis SL, et al. Cognitive-Behavioral-Based Physical Therapy for Patients with Chronic Pain Undergoing Lumbar Spine Surgery: A Randomized Controlled Trial. J Pain. 2016;17(1):76–89. PMID: 26476267 https://doi. org/10.1016/j.jpain.2015.09.013

64. Strøm J, Høybye MT, Laursen M, Jørgensen LB, Nielsen CV. Lumbar Spine Fusion Patients’ Use of an Internet Support Group: Mixed Methods Study. J Med Internet Res. 2019;21(7):e9805. PMID: 31274113 https://doi.org/10.2196/jmir.9805

65. Scarone P, Smeets AYJM, van Kuijk SMJ, van Santbrink H, Peters M, Koetsier E. A randomized controlled TRIal of cognitive BEhavioral therapy for high Catastrophizing in patients undergoing lumbar fusion surgery: the TRIBECA study. BMC Musculoskelet Disord. 2020;21(1):810. PMID: 33276768 https://doi.org/10.1186/s12891-020-03826-w

66. Parrish J, Jenkins N, Parrish M, Cha EDK, Lynch CP, Massel DH, et al. The influence of cognitive behavioral therapy on lumbar spine surgery outcomes: a systematic review and meta-analysis. Eur Spine J. 2021;30(5):1365–1379. PMID: 33566172 https://doi.org/10.1007/ s00586-021-06747-x

67. Kim HJ, Park JW, Chang BS, Lee CK, Yeom JS. The influence of catastrophising on treatment outcomes after surgery for lumbar spinal stenosis. Bone Joint J. 2015;97-B(11):1546–1554. PMID: 26530659 https://doi.org/10.1302/0301-620X.97B11.36016

68. Mayo BC, Narain AS, Hijji FY, Massel DH, Bohl DD, Singh K. Preoperative Mental Health May Not Be Predictive of Improvements in PatientReported Outcomes Following a Minimally Invasive Transforaminal Lumbar Interbody Fusion. Int J Spine Surg. 2020;14(1):26–31. PMID: 32128299 https://doi.org/10.14444/7003