The impact of preoperative mindfulness-based stress reduction on postoperative outcomes in lumbar spine degenerative disease: 3- and 12-month results of a pilot study.


Author: Chavez JL1, Porucznik CA2, Gren LH2, Guan J3, Joyce E3, Brodke DS4, Dailey AT3, Mahan MA3, Hood RS3, Lawrence BD4, Spiker WR4, Spina NT4, Bisson EF3

Affiliation: <sup>1</sup>Department of Neurosurgery, Clinical Neurosciences Center, University of Utah Health Sciences Center, Salt Lake City, Utah, USA. Electronic address: June.Yi@hsc.utah.edu.

<sup>2</sup>Division of Public Health, Department of Family and Preventive Medicine, University of Utah School of Medicine, Salt Lake City, Utah, USA.

<sup>3</sup>Department of Neurosurgery, Clinical Neurosciences Center, University of Utah Health Sciences Center, Salt Lake City, Utah, USA.

<sup>4</sup>Department of Orthopaedic Surgery, University of Utah Health Sciences Center, Salt Lake City, Utah.
Conference/Journal: World Neurosurg.
Date published: 2020 Apr 9
Other:
  Pages: S1878-8750(20)30657-4   ,  Special Notes: doi: 10.1016/j.wneu.2020.03.186. [Epub ahead of print]   ,  Word Count: 257  
    BACKGROUND: We previously reported inpatient and 30-day postoperative patient-reported outcomes (PROs) of a controlled, non-crossover pilot study utilizing preoperative mindfulness-based stress reduction (MBSR) training for lumbar spine surgery. Our goal here was to assess 3- and 12-month postoperative PROs of preoperative MBSR in lumbar spine surgery for degenerative disease.



METHODS: Intervention group participants were prospectively enrolled in a preoperative online MBSR course. A comparison standard care-only group was one-to-one matched retrospectively by age, sex, surgery type, and prescription opioid use. Three- and 12-month postoperative PROs for pain, disability, quality of life, and opioid use were compared within and between groups. Regression models were used to assess whether MBSR use predicted outcomes.



RESULTS: Twenty-four participants were included in each group. At 3 months, follow-up was 87.5% and 95.8% in the comparison and intervention groups, respectively. In the intervention group, mean PROMIS-PF was significantly higher while mean PROMIS-PI and ODI were significantly lower. The change from baseline in mean PROMIS-PF and PROMIS-PI were significantly greater than in the comparison group. At 12 months, follow-up was 58.3% and 83.3% in the comparison and intervention groups, respectively. In the intervention group, mean PROMIS-PI was significantly lower and change in mean PROMIS-PI from baseline was significantly greater. MBSR use was a significant predictor of change in PROMIS-PF at 3 months and in PROMIS-PI at 12 months. No adverse events were reported.



CONCLUSIONS: Three- and 12-month results suggest preoperative MBSR may have pain-control benefits in lumbar spine surgery.



Copyright © 2020 Elsevier Inc. All rights reserved.



KEYWORDS: degenerative disease; lumbar spine surgery; mindfulness-based stress reduction; patient-reported outcomes; prescription opioids



PMID: 32278820  DOI: 10.1016/j.wneu.2020.03.186