00152232-201010001-00047MiscellaneousSpine: Affiliated Society Meeting AbstractsSpine: Affiliated Society Meeting Abstracts© 2010 Lippincott Williams & Wilkins, Inc.October 2010
p 47LUMBAR DISC HERNIATION IN THE SPINE PATIENT OUTCOMES RESEARCH TRIAL (SPORT): DOES PSYCHOLOGICAL DISTRESS AFFECT TREATMENT OUTCOME?47.ORAL PRESENTATIONSAlbert, Anthony MD; Davis, Garrett MD, MBA; Spratt, Kevin PhD; Abdu, William MD, MS; Zhao, Wenyan MS; Weinstein, James N. DO, MSc.Lebanon, NH, USAINTRODUCTION: A generally held clinical impression is that patients with psychological Distress (PD, e.g., Depression, Anxiety, Bi-Polar Disorder) are likely to have poorer treatment outcomes. The literature provides some support for this impression, but the generalizability across patient cohorts and evidence for a causal link between PD and outcome remain controversial.METHODS: Patients with lumbar intervertebral disc herniations (IDH) were studied. Patients with MCS scores <= 35 were defined as having PD and, otherwise, were classified as not distressed (Non-PD). Longitudinal regression models including baseline covariates were used to control for confounding when evaluating patients' Bodily Pain (BP), Physical Function (PF) and Oswestry Disability Index (ODI) outcomes.RESULTS: The SPORT IDH cohort included 1190 patients: 66% underwent surgery, and 22% reported being depressed at baseline. Change from baseline in PF outcome at 1- and 2-year follow-up for surgical and non-operative PD and Non-PD patients at baseline are summarized below.JOURNAL/spinea/04.03/00152232-201010001-00047/table1-47/v/2021-02-17T195504Z/r/image-jpegNo caption available.Surgical patients demonstrated greater average improvement than non-operative patients for all three outcomes, p<.0001. However, PD patients treated non-operatively demonstrated less improvement than Non-PD patients. In contrast, differences in outcomes in patients with and without PD who underwent surgical intervention were neither statistically significant nor clinically relevant.DISCUSSION: In this IDH patient cohort, surgical outcomes were unrelated to baseline PD, but, for patients treated non-operatively, the average amount of improvement from baseline for PD patients was not as good as for non-PD patients. These results are consistent with the notion that patient non-compliance – mediated by PD – may be a more reasonable explanation for reduced treatment efficacy when treatment requires greater patient participation.<strong xmlns:mrws="http://webservices.ovid.com/mrws/1.0">LUMBAR DISC HERNIATION IN THE SPINE PATIENT OUTCOMES RESEARCH TRIAL (SPORT): DOES PSYCHOLOGICAL DISTRESS AFFECT TREATMENT OUTCOME?</strong>: <strong xmlns:mrws="http://webservices.ovid.com/mrws/1.0">47.</strong>Albert Anthony MD; Davis, Garrett MD, MBA; Spratt, Kevin PhD; Abdu, William MD, MS; Zhao, Wenyan MS; Weinstein, James N. DO, MSc.ORAL PRESENTATIONSORAL PRESENTATIONSp 47
