Pre-surgical psychological screenings for lumbar fusion: A look at real world practice (original) (raw)

Psychology, Health & Medicine, 2002

Abstract

Candidates for lumbar fusion are often referred for psychological evaluation prior to surgery in order to identify psychosocial issues that may complicate outcomes and provide recommendations for how to ameliorate these potential problems. The long-term goal of such evaluations is to optimize successful surgical outcomes. The purpose of this study was to examine a cohort of compensated lumbar fusion patients from Utah who underwent pre-surgical psychological evaluation ( n = 29) and to compare their surgical outcomes with patients who did not have these evaluations ( n = 115). A retrospective cohort design was utilized that included a pre-surgical medical chart review and a post-surgical telephone survey with patients at least two years following surgery. Results indicated that patients referred for psychological evaluations had higher levels of pre-surgical alcohol use and depression, and following surgery had longer recovery times, higher medical and compensation costs and disability rates than other fusion patients. The two cohorts did not differ in terms of patient satisfaction, back pain-related impairment or general health status. The significance of these findings for surgical decisions, rehabilitation interventions and professional psychological practice is discussed.

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