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Related Experiment Videos

The distress and risk assessment method (DRAM).

J L Hobby1, L N Lutchman, J M Powell

  • 1Ipswich Hospital NHS Trust and the Orthopaedic Research Unit, University of Cambridge, England, UK.

The Journal of Bone and Joint Surgery. British Volume
|March 14, 2001
PubMed
Summary

Preoperative psychological disturbance does not impact lumbar discectomy outcomes. Surgery is recommended for symptomatic prolapsed intervertebral discs regardless of psychological assessment results.

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Area of Science:

  • Neurosurgery
  • Psychology

Background:

  • Preoperative psychological distress can influence patient outcomes.
  • The impact of psychological disturbance on lumbar discectomy results requires further investigation.

Purpose of the Study:

  • To assess the influence of preoperative psychological disturbance on lumbar discectomy outcomes.
  • To determine if psychological assessment should affect surgical candidacy for prolapsed intervertebral discs.

Main Methods:

  • 66 patients undergoing lumbar discectomy were evaluated pre- and post-operatively.
  • Oswestry disability index and Distress and Risk Assessment Method (DRAM) scores were used.
  • Patients were categorized into normal, at-risk, or distressed groups.

Main Results:

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  • Preoperative disability was higher in psychologically disturbed patients.
  • Postoperative disability scores at six months did not differ significantly between groups.
  • Psychological disturbance scores improved following surgery.

Conclusions:

  • Early outcomes of lumbar discectomy are not adversely affected by preoperative psychological disturbance.
  • Preoperative psychological assessment should not be a barrier to surgery for symptomatic prolapsed intervertebral discs.