腰部脊柱管狭窄における除圧術の手術成績とBS-POPによる精神医学的問題評価との関係―BS-POPの手術前後での変化に着目した前向き研究

Relation Between Surgical Treatment Outcomes and Psychiatric Problems in Lumbar Spinal Stenosis. A Prospective Cohort Study

　背景：腰部脊柱管狭窄において，術前後の整形外科患者に対する精神医学的問題評価のための簡易質問票(以下，BS-POP)と手術成績との関係を検討した．

　方法：腰部脊柱管狭窄に対して後方除圧術を施行した189例を対象とした．対象を術前のBS-POPで，正常群と異常群に分けて前向きに比較検討した．

　結果：術前にBS-POPが異常を示した患者のうち，約7割は術後1年でBS-POPが正常化した．BS-POPの異常が術後も残存する，あるいは正常から異常へ悪化する患者は，術前・術後ともにBS-POPの正常を維持した患者と比較して，手術成績が不良であった．

　結論：BS-POPによる評価は，手術前後で変化しうる．今後は，術後のBS-POPの変化を含めて，術前に予測する因子をさらに検討する必要がある．

　Background：We evaluated the relationship between the surgical treatment outcomes of lumbar spinal stenosis patients and their scores on the Brief Scale for Psychiatric Problems in Orthopaedic Patients (BS-POP).

　Method：The subjects were 189 lumbar spinal stenosis patients who were treated by posterior decompression surgery.　Based on their preoperative BS-POP scores, the subjects were divided into a normal score group and an abnormal score group, and the groups were compared prospectively.

　Results：At 1 year after surgery the scores of 70% of the patients with abnormal BS-POP scores preoperatively had improved to normal BS-POP scores.　The groups with abnormal BS-POP scores postoperatively had poorer surgical outcomes than the group with normal preoperative and postoperative BS-POP scores.

　Conclusion：The results of evaluations for psychiatric problems by the BS-POP can be different before and after surgery.　The results of our study indicate that other predictive factors should be explored to predict changes in BS-POP scores between before and after surgery.