An Evaluation of Presurgical Psychological Screening as a Predictor of Outcome for Total Disc Replacement




Austin, Sabrina Stirling

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A long-term follow-up study was conducted to evaluate the efficacy of presurgical psychological screening (PPS) in predicting the response to treatment by patients undergoing Total Disc Replacement (TDR). Subjects participated in a psychological screening prior to surgery and were given a prognosis that was then used to determine whether they were fit to proceed with surgery. All participants in this study had a prognosis of Good (G), Fair-Good (FG), or Fair (F). Subjects were followed for one year and reported on measures of pain and functional disability at baseline, 6 months, and 12 months. G subjects showed significantly greater improvement in both pain and restoration of function than F subjects. G subjects also had significantly greater pain reduction than FG subjects. SCL-90 response patterns were detected in data but were not found to be predictive of outcome on either pain reduction or functional restoration measures. PAIRS scores were shown to correlate with baseline measures of functional disability but analyses were not able to determine whether these scores could predict treatment outcome. These findings suggest that PPS is an effective tool in predicting a patient's response to TDR.

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