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:
1Department of Neurosurgery, Clinical Neurosciences Center, University of Utah Health Sciences Center, Salt Lake City, Utah, USA. Electronic address: June.Yi@hsc.utah.edu.
2Division of Public Health, Department of Family and Preventive Medicine, University of Utah School of Medicine, Salt Lake City, Utah, USA.
3Department of Neurosurgery, Clinical Neurosciences Center, University of Utah Health Sciences Center, Salt Lake City, Utah, USA.
4Department 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
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