Psychological Predictors of Outcomes with Lumbar Spinal Fusion: A Systematic Literature Review.

Abstract

Purpose

To review the predictive/risk psychological factors at baseline that are associated with a favourable (or non-favourable) outcome following lumbar spinal fusion (LSF).

Methods

A computer-assisted literature search of PubMed, CINAHL complete and EMBASE for studies published between January 1, 1990 and October 1, 2014 with controlled vocabulary and key words related to LSF, degenerative lumbar spine diagnoses and appropriate terms for predictive variables. Each study was required to be a retrospective or prospective design that involved LSF (all forms). Quality assessment was conducted with the Quality In Prognosis Studies tool. A study protocol was registered with the International Prospective Register of Systematic Reviews (PROSPERO# CRD42014008728).

Results

The majority of the eight accepted studies were observational, prospective cohorts (n = 6). High levels of baseline depression and lower SF-36 Mental Component Scores (MCS) lower quality of life were associated with non-favourable outcomes. Two studies were rated as high quality, five were moderate and one study had low quality.

Conclusions

At present, there are a number of psychological variables that are associated with a poorer outcome with LSF. Higher levels of depression and lower scores on the SF-36 MCS are the most commonly implicated. However, based on the results of the studies using single arm designs there is not enough evidence to determine which psychological variables are influential in predicting outcomes for LSF. Copyright © 2015 John Wiley & Sons, Ltd.

Department

Description

Provenance

Citation

Published Version (Please cite this version)

10.1002/pri.1648

Publication Info

Wilhelm, Mark, Michael Reiman, Adam Goode, William Richardson, Christopher Brown, Daniel Vaughn and Chad Cook (2017). Psychological Predictors of Outcomes with Lumbar Spinal Fusion: A Systematic Literature Review. Physiotherapy research international : the journal for researchers and clinicians in physical therapy, 22(2). 10.1002/pri.1648 Retrieved from https://hdl.handle.net/10161/31406.

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Scholars@Duke

Reiman

Michael Patrick Reiman

Associate Professor in Orthopaedic Surgery

Dr. Reiman is a clinical & didactic teacher & researcher, physical therapist, athletic trainer and profession advocate with a long-term history of clinical care excellence and service. His passions include refining and improving the patient care and educational pedagogy. Dr. Reiman has authored or co-authored 4 textbooks, has published over 100 peer reviewed manuscripts and lectures internationally on orthopedic and sports rehabilitation, including return to activity and sport determination.

Goode

Adam Payne Goode

Professor in Orthopaedic Surgery

Dr. Goode is an Associate Professor in the Department of Orthopedic Surgery. He is a physical therapist by clinical training and epidemiologist by scientific training. His focus is on understanding the etiology of low back pain and other chronic musculoskeletal conditions and improving the delivery of care for patients with acute and chronic musculoskeletal conditions.  In his research he has published in the areas of the relationship between individual radiographic features in the lumbar spine and clinical symptoms, biomarkers and peripheral joint osteoarthritis. 

Brown

Christopher Robert Brown

Assistant Professor of Orthopaedic Surgery

As an orthopaedic specialist and spine surgeon, I am committed to providing the best possible outcome for my patients with the least invasive surgery possible. I treat patients using the latest minimally invasive surgical techniques. Among the conditions I see in my patients are cervical radiculopathy and myelopathy, and traumatic spine injuries. Among the procedures I perform are complex cervical reconstruction, disc replacement surgery, minimally invasive scoliosis surgery, motion preservation spine surgery, and metastatic and tumor surgery.

Cook

Chad E. Cook

Professor in Orthopaedic Surgery

Dr. Cook is a clinical researcher, physical therapist, and profession advocate with a long-term history of clinical care excellence and service. His passions include refining and improving the patient examination process and validating tools used in day-to-day physical therapist practice. Dr. Cook has authored or co-authored 3 textbooks, has published over 315 peer reviewed manuscripts and lectures internationally on orthopedic examination and treatment.


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