Analysis of the depression and anxiety status and related risk factors in patients with lumbar disc herniation.

OBJECTIVES: To evaluate the depression and anxiety status and related risk factors in patients with lumbar disc herniation, and help spine surgeons better identify those patients who need psychological care. METHODS: A cross-sectional study was performed on patients with lumbar disc herniation treated in our hospital between October 2015 and August 2018. Visual analog scale and Oswestry disability index were used to assess pain intensity and lumbar function, and Zung self-rating depression and anxiety scale were employed to evaluate the depression and anxiety status of the patients, and the demographic and clinical data including age, gender, marital status, occupation type, employment status, education level, surgery history, herniation type, disease duration, and insurance status were collected for analysis. RESULTS: In the current study, 165 patients were enrolled based on the inclusion and exclusion criteria. In multivariate logistic regression analysis, gender (p=0.03), pain intensity (p=0.01), self-rating anxiety scale (SAS) (p=0.00), and disease duration (p=0.001) were identified as independent risk factors for depression status, and pain intensity (p=0.02), disease duration (p=0.002) and SDS (Zung self-rating depression scale) (p=0.003) were independent risk factors for anxiety status in patients with lumbar disc herniation. There was a significant correlation between Zung self-rating depression and anxiety scale in patients with lumbar disc herniation (p<0.05). CONCLUSION: Psychological intervention is critical for patients with lumbar disc herniation, especially for those female patients with severe pain and longer disease duration.

Comparison of two types of exercises in the treatment of lumbar spinal stenosis.

OBJECTIVE: To evaluate the efficacy of core stability exercise versus conventional exercise in the treatment of lumbar spinal stenosis. METHODS: Between January 2014 and May 2017, patients with lumbar spinal stenosis were recruited and divided into group of core stability exercise or conventional exercise randomly. All the patients were treated using middle frequency electrotherapy, in addition to that, the patients in group of core stability exercise were treated using core stability exercise. The patients in group of conventional exercise were treated using conventional exercise. The outcome was evaluated using Japanese Orthopedic Association (JOA) score, self-reported walking capacity and lumbar lordosis angle at baseline and after treatment. RESULTS: In the current study, sixty-two patients with lumbar spinal stenosis met the inclusion and exclusion criteria, in which 33 patients were included in group of core stability exercise and 29 in group of conventional exercise. After treatment, both Japanese Orthopedic Association scores (p<0.05) and self-reported walking capacity (p<0.05) increased significantly in each group when compared with baseline. The self-reported walking capacity and JOA scores in the group of core stability exercise were significantly higher than those in the conventional exercise group (p<0.05). However, both the intragroup and intergroup comparison of lumbar lordosis presented with no significance (p>0.05). CONCLUSION: Core stability exercise presents with better efficacy than conventional exercise in the treatment of lumbar spinal stenosis.