Introduction

Psychosocial factors are associated with poor postoperative outcomes in lumbar spinal stenosis (LSS). The purpose of this study was to investigate the effect of psychosocial factors on the postoperative outcome of LSS in a multidimensional manner using the Japanese Orthopaedic Association Back Pain Evaluation Questionnaire (JOABPEQ).

Methods

The subjects were 118 patients (65 males and 53 females, mean age 64.7 years) who underwent LSS surgery at our hospital. Preoperatively, the patients were classified into two groups, normal and abnormal, using Brief scale for evaluation of psychiatric problems in orthopedic patients (BS-POP). They were evaluated preoperatively and at three months, one year, and three years postoperatively using the JOABPEQ. Mann-Whitney's U test was used for the statistical study (p < 0.05).

Results

JOABPEQ scores (normal group/abnormal group; preoperative, 3 months, 1 year, 3 years postoperative) were as follows: pain-related disability (28.6/42.9, 78.6/71.4, 100/71.4, 100/64.3), lumbar dysfunction (50.0/50.0, 83.3/58.3, 83.3/33.3, 100/70.8) gait impairment (28.6/21.4, 71.4/28.6, 75.0/46.4, 92.9/64.3), social impairment (43.2/32.4, 56.8/45.9, 64.9/51.4, 78.4/54.1), and psychological impairment (41.7/45.6, 60.2/47.6, 57.3/52. 4, 69.4/42.2). The BS-POP abnormal group had significantly lower scores for lumbar spine dysfunction at three months and one year postoperatively. For social disability, the score was significantly lower at one year postoperatively. Low back pain, lower extremity pain, and numbness were significantly lower at three months postoperatively.

Discussion

When considering surgery for LSS in patients with psychosocial factors, it would be necessary to select a treatment method after providing adequate explanations to patients based on the characteristics shown in this study.