Psychosocial Factors and Patient Outcomes in Spine Surgery

Psychosocial factors such as depression, anxiety, coping strategies and social support profoundly influence perioperative experiences, pain perception, functional recovery and satisfaction following spine surgery. Preoperative mood disorders can predispose patients to heightened postoperative pain, impaired rehabilitation adherence and delayed return to daily activities. Anxiety and depressive symptoms correlate with increased disability scores and risk of chronic pain states. Conversely, structured psychological interventions, multidisciplinary care and patient education may mitigate distress, enhance self-efficacy and improve outcomes. Frailty and multimorbidity intersect with psychosocial dimensions, particularly in elderly cohorts, where minimally invasive techniques reduce physiological stress but may not fully offset the impact of underlying emotional factors. Patient-centred approaches that integrate routine screening for psychological risk, individualised counselling and targeted mental health support have demonstrated reductions in perioperative morbidity and improved long-term function. Emerging research underscores the global significance of addressing psychosocial determinants to optimise resource utilisation, inform preoperative counselling and tailor rehabilitation pathways, thereby achieving more consistent and equitable patient outcomes in diverse healthcare settings.

Research from Nature Portfolio

Recent studies have highlighted the safety and efficacy of full-endoscopic spine surgery in elderly and frail patients. Using propensity score matching and the Charlson Comorbidity Index to stratify risk, investigators found equivalent short-term pain relief across comorbidity groups and comparable emergency readmission rates, although those with higher frailty indices experienced longer hospital stays and marginally reduced functional gains at chronic follow-up. In patients undergoing surgery for degenerative lumbar spinal stenosis, baseline depression – but not anxiety – was consistently associated with more severe symptoms and poorer functional scores at 12 and 24 months, as assessed by standardised symptom and function scales, though both depressed and non-depressed cohorts achieved similar proportions of clinically meaningful improvement. These findings underscore the importance of preoperative psychological assessment in surgical decision-making and postoperative care planning.

Psychosocial Factors and Patient Outcomes in Spine Surgery publication trend

The graph below shows the total number of articles in psychosocial factors and patient outcomes in spine surgery across all publications each year (not limited to Nature Index journals).

Technical terms

Full-endoscopic spine surgery: A minimally invasive surgical technique using an endoscope to access and treat spinal pathologies through small incisions, reducing tissue trauma and recovery time.

Charlson Comorbidity Index (CCI): A weighted scoring system to assess patient comorbidity burden and predict postoperative mortality and morbidity risk.

Propensity score matching: A statistical method that balances baseline characteristics between groups in observational studies to reduce selection bias.

Hospital Anxiety and Depression Scale (HADS): A self-reported questionnaire used to screen for anxiety and depression symptoms in medical settings.

Minimal clinically important difference (MCID): The smallest change in an outcome measure perceived as beneficial by patients, indicating a meaningful improvement.

References

1. Effects of nurses-led multidisciplinary-based psychological management in spinal surgery: a retrospective, propensity-score-matching comparative study. BMC Nursing (2024).
2. Full-endoscopic spine-surgery in the elderly and patients with comorbidities. Scientific Reports (2024).
3. How Does Anxiety and Depression Affect the Outcome after Periradicular Infiltration Therapy?—A Retrospective Analysis of Patients Undergoing CT-Guided Single-Level Nerve Root Infiltration Due to Chronic Monoradicular Pain. Diagnostics (2023).
4. Depressive symptoms during rehabilitation period predict poor outcome of lumbar spinal stenosis surgery: A two-year perspective. BMC Musculoskeletal Disorders (2010).
5. Association between depression and anxiety on symptom and function after surgery for lumbar spinal stenosis. Scientific Reports (2022).