| ObjectiveTo determine the prognostic correlation of surgery outcomes and -preoperative/postoperative score or postoperative symptom - sign improving rate in patients with lumbar disc herniation.Materials and methods107 patients with lumbar disc herniation who underwent the surgical procedures in the 2nd hospital of China Medical University over a 13 - month period between April of 2001 and May of 2002 were included in this study. They consisted of 59 men and 48 women, having a mean age of 44. 13 years. The following detailed personal data including gender, age, family address, postal code, and telephone number were recorded preoperatively. Sex, age, work character, culture level , smoking history, preoperative course of disease preoperative pain time and severity were recorded and scored according to visual analog scale (VAS) , in addition to score preoperative symptoms and signs.SDS(Self - Rating Depression Scale) , which was developed by Zung in 1965, was used to evaluate preoperative depression. According to SAS, the score of the normal group was less than 53, and that of the depression group was more than 53.Preoperative anxiety was evaluated by SAS ( Self - Rating Anxiety Scale) , which was developed by Zung in 1971. According to SAS, the score was less than 50 in the normal group and more than 50 in the anxiety group.The evaluation of surgical outcomes was by the scale table combining 60 items of North American Spine Society and our clinical experiences. The current study quantified and focused on preoperative symptoms and functions with a total score of 100, and postoperative follow- up scale excluded the scoring of CT or MRI examination. In the postoperative questionnaire, we supplemented the investigation of life and work ability. The symptom improving rate and the symptom - sign improving rate were calculated by the following formula respectively, (the score of preoperative symptoms - that of postoperative symptoms ) / the score of preoperative symptoms, (the score of preoperative symptoms and signs - that of postoperative symptoms and signs) / the score of preoperative symptoms and signs.Statistical analysis of outcomes was managed by SPSS 10. 0 software . No statistic difference existed between depression group and non- depression group as well as anxiety group and non - anxiety group about sex, age, work character, culture level smoking history, preoperative course of disease and preoperative general grade, t test for independent samples between depression group and non - depression group as well as anxiety group and non ?anxiety group were performed about preoperative pain score , postoperative pain frequency, degree, symptom improving rate and symptom - sign improving rate. Statistic difference existed in normal group and only depression group, only anxiety group, depression and anxiety group.ResultsAll 107 patients underwent follow - up studies for 6. 0 - 21. 1 months successfully. The average follow - up period was 11. 2 months. The preoperative scoring of visual analog scale (VAS) , SDS and SAS were 5. 67 ± 1. 54, 45. 55 ±9. 79, 44. 72 ± 11. 53 respectively. The postoperative improving rate was 78. 27 ±21. 10%. A-mong 107 patients, 25 patients (23.4%) were in depression group and 31 patients (29.0%) belonged to anxiety group.The scoring of visual analog scale ( VAS) in depression group was significantly high comparing to non - depression group. There were more often and severer postoperative pain as well as poorer symptom improving rate ( P < 0. 05 ) in patients of depression group. There was a significantly statistical difference in postoperative work a-bility and the symptom - sign improving rate between depression and non - depression group ( P <0. 05 , P <0. 01 ) .No statistical difference was observed in the preoperative course and total scoring between the anxiety and non - anxiety group. There was a notable difference in postoperative pain frequency, degree and symptom improving rate between the anxiety and non - anxiety group ( P... |
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