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Spine Surgery & Preoperative Psychological Assessments

Spine Surgery & Preoperative Psychological Assessments

The United States Preven-tive Services Task Force (USPSTF) recommends that pre-surgical psychological screening (PPS) be used in clinical practice to assure that a patient’s diagnosis is correct, to identify those at risk for poor outcomes, and to provide effective treatment and follow-up services. PPS involves referring patients—including those with chronic pain who are considering spine surgery—to a health psychologist for further evaluation. This usually involves a semi-structured interview and psychometric testing. Studies suggest that few adults with depression and anxiety seek care, but these conditions may play a role in disabling back pain and contribute to poor health outcomes. The USPSTF recommendations were developed in response to the realization that many psychological disorders go untreated. “These illnesses are often overlooked,” explains Richard L. Skolasky, ScD, “but they could pose serious risks to patients and may influence recovery.” Previous research has linked depression and anxiety to longer recuperation time, delayed returns to work, more postoperative complications, and failure to comply with medication schedules after discharge. Examining Use of PPS Little is known about how often PPS is used by spine surgeons or the factors that may affect its use. To address this research gap, Dr. Skolasky and colleagues conducted a study to estimate the prevalence of PPS use among spine surgeons in the U.S. The study, published in the Journal of Spinal Disorders and Techniques, also sought to identify factors associated with the use of PPS and evaluate spine surgeons’ opinions of PPS. The quality of patient care may improve by gaining a better understanding of the factors contributing to the use of PPS. For the analysis, an online survey...
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