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Updated: Sep 13, 2025
Evaluation of Patients' Posture and Gait Profile After Lumbar Fusion Surgery by Video Rasterstereography and Treadmill Gait Analysis
Published on: March 23, 2019
Effect of Depressive Symptoms on Return to Work After Lumbar Spine Fusion Surgery: A Retrospective Registry Study
Jenna L C Laurén1,2,3, Leevi A Toivonen2,3, Jussi P Repo2,3
1Department of Surgery, Hospital Nova of Central Finland, Jyväskylä, Finland.
Study Design:
Retrospective registry study.
Objective:
To investigate the influence of depressive symptoms on return to work (RTW) after lumbar spine fusion (LSF) surgery over a two-year follow-up. A secondary objective was to evaluate the development of depressive symptoms separately in patients who succeeded or failed to RTW after surgery.
Background:
Depressive symptoms are overrepresented in patients undergoing LSF surgery. The effect of depressive symptoms on RTW after LSF surgery has not yet been widely studied.
Materials And Methods:
A total of 348 consecutive patients available to the workforce underwent LSF surgery. Depressive symptoms were evaluated at baseline and three, 12, and 24 months postoperatively using the MHI-5. Lower scores have been shown to indicate greater depressive symptoms, and a cutoff score of ≤68 indicates current major depressive disorder (MDD). Cumulative RTW and MHI-5 scores were prospectively followed up at the aforementioned time points.
Results:
Before surgery, almost half (46%) of the patients had MDD. The presence of preoperative MDD indicated a lower RTW at two years [72% vs . 82%, adjusted HR: 0.77 (95% CI: 0.61 to 0.98)]. The probability of RTW was correlated with an increase in the MHI-5 score until the inflection point of 70, after which a further increase in the MHI-5 score no longer increased the probability of RTW. In addition, the MHI-5 score was significantly higher than baseline at three months postoperatively [13 points (95% CI: 10 to 15)] and remained higher in patients who RTW during two years. However, only a marginal increase in MHI-5 was observed in those who failed to RTW. This finding indicates fewer depressive symptoms in patients who successfully RTW.
Conclusion:
Patients with preoperative MDD were less likely to RTW after LSF surgery. After surgery, depressive symptoms diminished in the group who did successfully RTW.
Level Of Evidence:
Level III.
