Patients with cervical disease may have high levels of preoperative psychological distress
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Results showed an overall higher level of psychological distress at baseline among patients undergoing surgery for cervical degenerative disease compared with historical controls of lumbar patients.
In a subset analysis of a prospective, double-blind, randomized controlled trial, Shaleen Vira, MD, and colleagues screened 47 patients undergoing surgical treatment for primary cervical degenerative disease for psychological distress using the fear-avoidance beliefs questionnaire (FABQ) and the pain catastrophizing scale (PCS). At baseline, researchers assessed patient outcome expectation, neck disability index (NDI) and EuroQOL-5D.
“Patients were stratified by psychological burden severity as previously published,” Vira said in his presentation at the North American Spine Society Annual Meeting. “Cutoffs and statistics were used to assess a relationship between baseline psychological distress and severity of disability by NDI.”
Vira noted 57.1% of patients had severe FABQ and 40% had severe PCS scores. Patients with cervical degenerative disease had greater levels of psychological distress by PCS scores and FABQ compared with historical controls of lumbar patients, according to Vira.
“Additionally, the fear of physical activity measured by the FABQ was found to be higher in patients with cervical deformity compared to historical values in patients with CAD, or coronary artery disease patients,” Vira said. “However, cervical patients had lower PCS scores compared to patients with CAD or lung cancer.”
Although the NDI positively correlated with PCS and FABQ, Vira noted the NDI negatively correlated with outcomes expectations. Psychological distress scores were not significantly correlated with total Charlson Comorbidity Index burden, age and BMI, according to Vira. However, he added the presence of liver disease and gastrointestinal complaints were associated with increasing NDI score.
“Baseline disability by NDI was found to have a significant relationship with having a severe PCS score, independent of levels fused and diagnosis,” Vira said. “This trend similarly identified severe FABQ, and age was not a significant predictor.”
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Passias PG, et al. Paper 223. Presented at: North American Spine Society Annual Meeting. Sept. 29 - Oct. 2, 2021; Boston (hybrid meeting).
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