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Predicting Disability After Lumbar Disc Surgery

Studies show that recovery from lumbar disc surgery can be slowed down by behavioral factors. Patients who are afraid to move or who worry about reinjury are more likely to have chronic pain and disability after low back surgery. Researchers are trying to figure out who might be at increased risk for this kind of problem before the surgery is done.

In this study, physical therapists test the role of cognitive-behavioral factors before surgery. They compare the results with patient disability after surgery. They expected that patients who were afraid to move or who expected a bad result would have more pain and disability after surgery.

All 310 patients in the study had low back pain from a disc problem. The diagnosis was lumbosacral radicular syndrome (LRS). Everyone had surgery to remove the damaged disc. Before the operation, pain intensity was measured. Pain-related fear of movement or reinjury was also measured before surgery.

Two other tests were also done. The first measured passive pain coping using a scale of worrying, resting, and retreating items. Resting referred to limiting activities because of pain. Retreating was based on the idea that pain would get worse with activity so sitting or lying down was needed.

The authors report older women who had more intense pain before the operation were more likely to have disability and pain after the surgery. This was true at six weeks and again at six months. Cognitive-behavioral factors were also important. Fear of movement and fear of reinjury were linked with more negative results.


Jasper J. den Boer, et al. Continued Disability and Pain After Lumbar Disc Surgery: The Role of Cognitive-Behavioral Factors. In Pain. July 2006. Vol. 123. No. 1-2. Pp. 45-52.

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