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Query: UMLS:C0011570 (depression)
 172,036 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

One hundred six patients with disc herniation who underwent lumbar laminectomy and discectomy and 51 patients with spinal stenosis who underwent decompressive lumbar laminectomy were evaluated for surgical outcome at least 1 year postoperatively (mean: 18 months). All had completed the Minnesota Multiphasic Personality Inventory (MMPI) as part of the preoperative evaluation. The Hypochondriasis (Hs), Depression (D), Hysteria (Hy), Psychopathic Deviate (Pd), Psychasthenia (Pt), and Schizophrenia (Sc) scales were found to be predictive of surgical outcome in the herniation group. However, no MMPI scale was related to outcome in the stenosis group. Analysis of covariance showed this fact to be related to the differences in age between the two groups of patients, rather than a result of the differing diagnoses. The MMPI appears to be more useful in predicting surgical outcome in the young and middle-aged adult patient population with disc herniation and is not of predictive utility in the older stenosis population.
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PMID:The differential utility of the Minnesota Multiphasic Personality Inventory. A predictor of outcome in lumbar laminectomy for disc herniation versus spinal stenosis. 381 Mar 3

The prognosis for patients treated surgically for lumbar spinal stenosis with a minimum follow-up time of 10 years was evaluated. The study group consisted of 102 patients (39 women and 63 men) with a mean age at operation of 52 years and with a mean follow-up time of 12.4 years. The antero-posterior (AP) diameter was equal to or less than 12 mm at the narrowest point on the preoperative lateral myelograms. The results were based on the Oswestry disability score, the severity of pain, the change in pain and the state of depression. According to this score the results were excellent-to-good in 69 patients (68%), the pain was mild in 64 patients (63%), the change in pain was slight in 78 patients (77%), and there was no depression in 55 patients (54%). The pain and the change in pain had a very high correlation in the Oswestry disability score. The pain led to depression more often in the men than in the women. The depression had a much stronger correlation to outcome in the men than in the women.
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PMID:The long-term prognosis after operation for lumbar spinal stenosis. 812 83

Twenty consecutive patients (10 men and 10 women; median age, 68 years) with lumbar spinal stenosis were studied before and after microsurgical decompression without laminectomy. Fourteen of the patients had pure stenosis symptoms, whereas six had intercurrent diseases that could exacerbate the symptoms of stenosis. The mean duration of symptoms was 4.5 years (range, 1 to 15 years). All patients were interviewed before operation, and an assessment form based on and modified from the Oswestry Low Back Pain Disability Questionnaire was completed. The ability to perform physical activities including house work, gardening, going to the post office, and so forth was markedly reduced before operation for nearly all patients, and social life such as traveling, meeting friends, and participating in hobbies was similarly restricted. Sleeping was also greatly affected before operation, as were psychological parameters including irritability, depression, infirmity, energy, patience, and concentration. At follow-up 2.8 years after surgery, 13 of the 14 patients with pure stenosis evaluated their quality of life as much improved and principally normal. Among the patients with intercurrent diseases, only two of six judged the quality of their lives as much improved.
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PMID:Quality of life before and after microsurgical decompression in lumbar spinal stenosis. 1087 62

It is well known that many elderly patients are referred to nursing homes because of "functional decline" without being thoroughly investigated. We studied 9 elderly patients, all referred to hospital due to functional decline and diagnosed as follows: spinal stenosis--2 cases, depression--3, thyrotoxicosis--1, Parkinson--1, polypharmacy and congestive heart failure--1 patient each. Proper diagnosis and appropriate treatment prevent unnecessary hospitalization in nursing homes. Our study is meant to draw attention to this crucial aspect of geriatric medicine.
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PMID:[Comprehensive geriatric assessment--its clinical, social and economic importance and prospects]. 1095 51

The case of a 77-year-old woman who was found dead in her bathtub with her head clearly above the water line is presented. The decedent had a medical history of depression, liver disease, spinal stenosis, and diabetes mellitus. An empty medication bottle of triazolam was found in the trashcan. At autopsy, no injury or evidence of drowning was found. Toxicological analysis identified triazolam at a concentration of 0.12 mg/L in the heart blood. Triazolam and alpha-hydroxytriazolam were quantitated in the specimens received. The medical examiner ruled that the cause of death was triazolam intoxication and the manner of death was suicide.
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PMID:Distribution of triazolam and alpha-hydroxytriazolam in a fatal intoxication case. 1188 17

The purpose of this study was to assess the outcome of peri-radicular infiltration for radicular pain in patients with spinal stenosis and lumbar disc herniation (LDH). Patients with spinal stenosis ( n=62) or LDH ( n=55) who met our criteria received fluoroscopically guided peri-radicular infiltration of local anaesthetic and steroid at the site of documented pathology. All the patients were followed-up at 3 months. There was a statistically significant difference in the functional outcome between the spinal stenosis group and the LDH group. The mean change in the Oswestry disability index (ODI) score for the spinal stenosis group was 5.5% compared to 12% for the LDH group. The spinal stenosis group had a mean change in visual analogue scales (VAS) of 1.2 compared to 2 for the LDH group. The higher the modified somatic perception score, modified zung depression and age at injection, the less favourable the outcome. There was a significantly better response to peri-radicular infiltration for radicular pain in patients with LDH than the spinal stenosis. Our findings help us to provide a better information for future patients. We do not know if this is a treatment effect or natural history of the pathology, as this is a cohort study and not a randomised controlled trial.
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PMID:Outcomes of a prospective cohort study on peri-radicular infiltration for radicular pain in patients with lumbar disc herniation and spinal stenosis. 1562 62

The effect of the duration of symptoms on the outcome of lumbar decompression surgery is not known. The aim of our study was to determine the predictors of functional outcome of lumbar decompression surgery for degenerative spinal stenosis with particular emphasis on the duration of symptoms. In this prospective cohort study, we recruited 100 patients with a full data set available at 1-year and 85% at 2-year follow-ups: 49 females and 51 males with an average age of 62 (range 52-82). The pre- and post-operative outcome measures were Oswestry disability index (ODI), low back outcome score (LBOS), pain visual analogue score (VAS), modified somatic perception (MSP) and modified Zung depression (MZD) score. Dural tear occurred in 14%, and there was one post-operative extra-dural heamatoma. Overall, the ODI improved from a pre-operative of 56 (+/-13) to a 1-year ODI of 40 (+/-22) and at 2-year ODI of 40 (+/-21). The VAS improved from an average of 8 to 5.2 at 1 year and 4.9 at 2 years. There was a statistical significant association between symptom duration and the change in ODI (P=0.007 at 1-year follow-up, P=0.001 at 2-year follow-up), LBOS (P=0.001 at 1-year follow-up, P<0.001 at 2-year follow-up) and VAS (P=0.003 at 1-year follow-up, P=0.001 at 2-year follow-up). Subgroup analyses showed that patients with symptom duration of less than 33 months had a more favourable result. In addition, the patients who rated the operation as excellent had a statistically significantly shorter duration of symptoms. We have not found a predictive value for age at operation, MSP or MZD. The number of levels of decompression and the different types of decompression surgery did not influence the surgical results. Our study indicates that the symptom duration of more than 33 months has a less favourable functional outcome.
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PMID:The effect of duration of symptoms on standard outcome measures in the surgical treatment of spinal stenosis. 1649 90

The objective of the study was to examine self-reported life satisfaction and associated factors in patients (n=100) with lumbar spinal stenosis (LSS) in secondary care level, selected for surgical treatment. Life satisfaction was assessed with the four-item Life Satisfaction scale. Depression was assessed with a 21-item Beck Depression Inventory (BDI). Psychological well-being was assessed with Toronto Alexithymia Scale and Sense of Coherence Scale. LSS related physical functioning and pain were assessed with Oswestry disability index, Stucki questionnaire, Visual Analogue Scale and pain drawings. All questionnaires were administered before surgical treatment of LSS. Results showed that 25% of the patients with LSS were found to be dissatisfied with life. In a univariate analysis, smoking, elevated subjective disability scores and extensive markings in the pain drawings were more common in the dissatisfied patients. The dissatisfied patients also showed lower coping resources, elevated alexithymia and depression scores, and were more often depressed. In multiple logistic regression analyses, only younger age and somatic comorbidity were associated with life dissatisfaction. This association remained significant even when the BDI score was added into the model. No other significant associations emerged. In conclusion, life dissatisfaction was rather common among preoperative LSS patients. Pain and constraints on everyday functioning were important correlates of life dissatisfaction. However, only younger age and somatic comorbidity were independently associated with life dissatisfaction. These results emphasize the importance of recognizing and assessing the effect of coexisting medical conditions and they need to be addressed in any treatment program.
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PMID:Somatic comorbidity and younger age are associated with life dissatisfaction among patients with lumbar spinal stenosis before surgical treatment. 1653 22

The objective of this study was to assess the correlation between neurogenic intermittent claudication (NIC) in LSS and different positions as well as loading status, using the treadmill device. The study was a prospective clinical trial on lumbar spinal stenosis (LSS) using a treadmill equipment. The study population comprised of 80 LSS patients with a mean age of 61. The equipment included a treadmill, unloading station and loading vests. The patients were instructed to walk in five different positions. The initiation time of symptoms and total walking time were recorded. The examination was stopped after 20 min or at the onset of severe symptoms. In order to obtain pretest demographic data on subjects, visual analog scale, Roland-Morris questionnaire, pain disability index, and Beck depression index were used. The initiation time of symptoms (ITS) and total walking time (TWT) were measured during the test. Unloading provided a longer and loading a shorter ITS and TWT. Decline or incline positions did not affect ITS or TWT. The changes in posture had no correlation with the appearance of symptoms in LSS patients with NIC on a treadmill in this study, rather ITS and TWT were determined by axial loading and unloading.
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PMID:Loading is more effective than posture in lumbar spinal stenosis: a study with a treadmill equipment. 1727 37

The objective of this observational prospective study was to investigate the effect of depression on short-term outcome after lumbar spinal stenosis (LSS) surgery. Surgery was performed on 99 patients with clinically and radiologically defined LSS, representing ordinary LSS patients treated at the secondary care level. They completed questionnaires before surgery and 3 months postoperatively. Depression was assessed with the 21-item Beck Depression Inventory (BDI). Physical functioning and pain were assessed with Oswestry disability index, Stucki Questionnaire, self-reported walking ability, visual analogue scale (VAS) and pain drawing. Preoperatively, 20% of the patients had depression. In logistic regression analyses, significant associations were seen between preoperative depression and postoperative high Oswestry disability and Stucki severity scores and high intensity of pain (VAS score). In subsequent analyses, the patients with continuous depression, measured with BDI (60% of the patients who had preoperative depression), showed fewer improvements in symptom severity, disability score, pain intensity and walking capacity than the patients who did not experience depression at any phase. In those patients who recovered from depression, according to BDI-scores (35% of the patients with preoperative depression), the postoperative improvement was rather similar to the improvement seen in the normal mood group. In the surgical treatment of LSS, we recommend that the clinical practice should include an assessment of depression.
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PMID:Depression is associated with poorer outcome of lumbar spinal stenosis surgery. 1739 27


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