July 24, 2017
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Depression linked with worse subjective outcomes after epidural steroid injection for spinal pathology

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Investigators found that after lumbar epidural steroid injection for degenerative spine disease, patients with depression had worse absolute scores for patient-reported outcomes and higher disability compared with patients who were not depressed.

“However, patients with depressive symptoms can expect similar improvement in [patient-reported outcomes] PROs at 12 months,” the researchers wrote.

Researchers used a prospective, web-based registry to evaluate 161 patients who underwent lumbar epidural steroid injections. At baseline and at 12 months postoperatively, investigators collected patient-reported outcomes. There were 71 patients classified as depressed and 90 patients were deemed not depressed, according to findings using the Zung Depression Scale. Scores were calculated for the change in patient-reported outcomes. Researchers performed multivariable linear regression analysis for Oswestry Disability Index (ODI), numeric rating scale (NRS) for leg pain and back pain, and EQ-5D scores.

Results showed patients who were depressed had significantly worse mean baseline patient-reported outcomes compared with patients who were not depressed. Investigators noted mean absolute scores for NRS back pain and leg pain, ODI and EQ-5D at 12 months postoperatively were significantly lower in patients who were depressed vs. those who were not, although there was no difference seen at 12 months in the mean change scores. At 12 months, after pre-procedure variables were adjusted, there was a correlation between a higher Zung Depression Scale score and higher disability. – by Monica Jaramillo

Disclosures: Kim reports no relevant financial disclosures. Please see the full study for a list of other authors’ relevant financial disclosures.