Comparison among pain, depression, and quality of life in cases with failed back surgery syndrome and non-specific chronic back pain.
Nilay Sahin, Ali Yavuz Karahan, Gul Devrimsel and 1 others
PMID 28603366WHAT IT FOUND
Patients with failed back surgery syndrome had more pain at rest and at night, and higher depression scores, than patients with non-specific chronic back pain.
Quality of life differed only in physical role limitations.
Key findings
01Patients with failed back surgery syndrome had higher pain at rest (3.8 vs 3.2), higher pain at night (3.5 vs 2.1), and higher depression scores (16.5 vs 13.2) than patients with non-specific chronic back pain (p<0.05).
02The only significant quality-of-life difference was role limitations due to physical functioning (p=0.02); other quality-of-life domains were not significantly different.
03The groups did not differ significantly in age, gender, body mass index, education level, or duration of pain.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
The methods text and tables give reversed group numbers, 50 versus 51. Pre-surgical psychological factors were not evaluated in the failed back surgery group, so baseline depression could not be ruled out. Ongoing neuropathic pain was not excluded, which could affect pain scores. Comorbid diseases that could trigger depression were not evaluated. Depression was assessed with a self-report questionnaire, not psychiatric interview. A cause and effect relationship between psychiatric disorders and physical pain cannot be fully determined.
The easy way to misread this
Do not conclude that failed back surgery caused worse pain or depression. The study compared two groups at one time point, did not assess pre-surgical psychological factors, and did not confirm psychiatric diagnoses, so it cannot show cause.