The pain experience and future expectations of chronic low back pain patients following spinal fusion

J Clin Nurs. 2008 Apr;17(7B):153-9. doi: 10.1111/j.1365-2702.2007.02234.x.

Abstract

Aim: In a sample of patients who underwent instrumented spinal fusions for chronic low back pain (CLBP), the purposes of this study were: to determine the amount of pain patients experienced and to determine the impact of length of time since surgery, use of pain medication and their outlook on the future on these pain intensity scores.

Background: An increasing number of people report CLBP and one of the treatments is instrumented fusion.

Method: The study used a cross-sectional design. Visual analogue scales were used to measure pain intensity in different locations and a single item measured patients' view of the future. Data were collected in November 2001.

Results: The sample consisted of 101 patients (71% women) aged 26-59 years treated with instrumented fusion 1-8 years ago. As many as 87% reported pain 1-8 years after the surgery. Most patients reported pain of low-to-moderate intensity in the neck and shoulders, back and hips, feet and legs and in total pain. As many as 45% of the patients did not take pain medication and patients using more analgesics reported more pain than those using fewer analgesics (p < 0.05). Patients with a more positive outlook on the future reported significantly less pain in all of the locations that were evaluated (p < 0.01).

Conclusion: A high percentage of patients with CLBP continue to experience pain 1-8 years after spinal fusion. A positive outlook towards the future seems to be associated with less pain in these patients. Relevance to clinical practice. Patients who continue to experience pain and have a more negative outlook on the future may benefit from psychoeducational interventions that teach them how to better cope with their pain.

MeSH terms

  • Adult
  • Analgesia / psychology
  • Analysis of Variance
  • Attitude to Health*
  • Chronic Disease
  • Cost of Illness
  • Cross-Sectional Studies
  • Female
  • Health Services Needs and Demand
  • Humans
  • Linear Models
  • Low Back Pain / diagnosis
  • Low Back Pain / etiology
  • Low Back Pain / psychology*
  • Low Back Pain / surgery
  • Male
  • Middle Aged
  • Negativism
  • Norway
  • Nursing Methodology Research
  • Pain Measurement
  • Pain, Postoperative / diagnosis
  • Pain, Postoperative / etiology
  • Pain, Postoperative / prevention & control
  • Pain, Postoperative / psychology*
  • Patient Education as Topic
  • Severity of Illness Index
  • Spinal Fusion / adverse effects*
  • Spinal Fusion / methods
  • Surveys and Questionnaires
  • Time Factors
  • Treatment Outcome