Responsiveness of depression and its influence on surgical outcomes of lumbar degenerative diseases.

Objective: To demonstrate the responsiveness of depression after surgery for lumbar degenerative disease and to verify the impact of this condition on surgical outcomes.

Patient Sample: A prospective cohort study with 91 patients with lumbar degenerative diseases who were evaluated preoperatively, at 30 days and 1 year postoperatively.

Outcome Measures: Evolution of depression between the follow-ups and its correlation with satisfaction.

Methods: Depression was assessed with Beck Depression Inventory. According to depression responsiveness, patients were classified into four groups: NN = no depression; ND = normal during the preoperative period and depression within 1 year; DN = depression during the preoperative period and normal within 1 year; DD = depression during the preoperative period and within 1 year.

Results: Prevalence of preoperative depression was 28.6% and 17.6% within 1 year postoperatively. Most patients (65.4%) with depression in the preoperative period recovered postoperatively. Poor preoperative HRQoL measures were associated with higher rates of responsiveness of depression during the follow-up. Patients with depression at the 1-year postoperative follow-up had a worse functional outcome. Patients who improved from depression had similar outcome to those without depression. Dissatisfaction within 1 year postoperatively was greater in patients who become depressed after surgery and remain depressed at 1-year follow-up (NN = 8.8%; ND = 42.9%; DN = 17.6%; DD = 44.4%; P = 0.012).

Conclusion: Most patients with depression in the preoperative recover within 1 year postoperatively. Responsiveness of depression is associated with surgical outcomes. The presence of depression after the surgical treatment, independent of when it starts, had a major negative impact on prognosis.