The Impact of Micro-Lumbar Discectomy on Preoperative Depressive Symptoms in Patients with Low Back Pain and Radiculopathy

Introduction: Lumbar microdiscectomy is one of the most frequently performed spinal surgeries. Depression and emotional distress are common psychological symptoms among patients suffering from lower back pain. Literature suggests that patients with depressive symptoms tend to experience poorer outcomes after spinal surgeries. However, the effect of micro-lumbar discectomy on emotional distress and mental well-being in these patients remains poorly understood.

Methods: Retrospective study of patients with lumbar disc herniation who underwent micro-lumbar-discectomy at our institution in 2023. Clinical outcomes were assessed using the Visual-Analog-Scale(VAS) for back and leg pain, the Oswestry-Disability-Index(ODI). The Modified-Zung-Self-Rating-Depression-Scale was used to measure the depression levels. Data were collected preoperatively and at postoperative intervals of day 0, 2 weeks, and 3 months.

Results: 23 patients(13 males and 10 females), 4(17.3%) exhibited no depressive symptoms preoperatively, while 13(56.5%) were identified as at risk for depression, and 3(13.0%) presented with distressed depression. The mean age of the study population was 47.1. At 3-months follow-up after microdiscectomy, 22 patients(95.7%) reported no depressive symptoms, with only one patient still experiencing distressed depression. There was a significant reduction(p < 0.001) in the mean Modified Zung score from 24.2 ± 10.6 preoperatively to 4.9 ± 4.7 at 3 months, indicating substantial improvement in patients' mental health status after the surgery. Additionally, significant reductions (p < 0.001) were observed in the mean ODI and VAS scores.

Conclusion : Micro-lumbar discectomy not only enhances functional outcomes for patients with persistent back pain and radiculopathy but also significantly alleviates symptoms of depression.