Abstract
Background Context
Even though catastrophizing can negatively moderate the outcome of surgery for lumbar
spinal stenosis (LSS), it is still unclear whether pain catastrophizing is an enduring
stable or a dynamic structure related to pain intensity after spine surgery.
Purpose
The purpose of this study was to determine whether catastrophizing would change in
patients who undergo spinal surgery for LSS.
Study Design
A prospective observational cohort study was carried out.
Study Sample
Patients who underwent spine surgery for LSS comprised the study sample.
Outcome Measures
The Visual Analog Pain Scale (VAS) scores for back/leg pain, Oswestry Disability Index
(ODI), and Pain Catastrophizing Scale (PCS) were the outcome measures.
Methods
The present observational cohort consisted of 138 patients between the ages of 40
and 80 years who were scheduled to undergo surgery for LSS. Among them, a total of
96 patients underwent a 3-year assessment after surgery. The PCS questionnaire was
used for pain catastrophizing assessment before and 3 years after surgery. The VAS
for back and leg pain, and ODI were assessed 3 and 6 months, and 1 and 3 years after
surgery. The correlations between variables were analyzed before and 3 years after
surgery. To clarify the causal relationship, time-series and linear mixed models were
also used.
Results
At 3 years after surgery, ODI, VAS for back and leg pain, and PCS scores were significantly
decreased. The correlation of PCS with VAS and ODI was significant both before and
3 years after surgery. The correlation between change in pain or disability and change
in pain catastrophizing from preoperative to 3 years after surgery was also significant.
In the causal relationship between pain and catastrophizing, overall changes in pain
and disability were significant predictors of overall changes in pain catastrophizing
from baseline to 3 year after surgery.
Conclusion
The present study shows that pain catastrophizing can change in association with the
improvement in pain intensity after spine surgery. Therefore, catastrophizing may
not be an enduring stable construct, but a dynamic construct.
Keywords
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Article info
Publication history
Published online: June 29, 2017
Accepted:
June 27,
2017
Received:
April 27,
2017
Footnotes
FDA device/drug status: Not applicable.
Author disclosures: HJK: Nothing to disclose. OHK: Nothing to disclose. BSC: Nothing to disclose. CKL: Nothing to disclose. HJC: Grant: National Research Foundation of Korea (Paid directly to institution/employer), pertaining to the submitted work. JSY: Nothing to disclose.
The disclosure key can be found on the Table of Contents and at www.TheSpineJournalOnline.com.
This research was supported by Basic Science Research Program through the National Research Foundation of Korea (NRF) funded by the Ministry of Education, Science and Technology (2016R1A2B3012850).
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