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Clinical Trial
. 2020 Jul:139:e230-e236.
doi: 10.1016/j.wneu.2020.03.186. Epub 2020 Apr 9.

The Impact of Preoperative Mindfulness-Based Stress Reduction on Postoperative Outcomes in Lumbar Spine Degenerative Disease: 3-Month and 12-Month Results of a Pilot Study

Juneyoung L Chavez  1 , Christina A Porucznik  2 , Lisa H Gren  2 , Jian Guan  3 , Evan Joyce  3 , Darrel S Brodke  4 , Andrew T Dailey  3 , Mark A Mahan  3 , Robert S Hood  3 , Brandon D Lawrence  4 , William R Spiker  4 , Nicholas T Spina  4 , Erica F Bisson  3
Affiliations
Clinical Trial

The Impact of Preoperative Mindfulness-Based Stress Reduction on Postoperative Outcomes in Lumbar Spine Degenerative Disease: 3-Month and 12-Month Results of a Pilot Study

Juneyoung L Chavez et al. World Neurosurg. 2020 Jul.

Abstract

Background: We previously reported inpatient and 30-day postoperative patient-reported outcomes (PROs) of a controlled, noncrossover pilot study using preoperative mindfulness-based stress reduction (MBSR) training for lumbar spine surgery. Our goal here was to assess 3-month 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-month 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 Patient-Reported Outcomes Measurement Information System-Physical Function (PROMIS-PF) was significantly higher, whereas mean Patient-Reported Outcomes Measurement Information System-Pain Interference (PROMIS-PI) and Oswestry Disability Index were significantly lower. The change from baseline in mean PROMIS-PF and PROMIS-PI was 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-month and 12-month results suggest that preoperative MBSR may have pain control benefits in lumbar spine surgery.

Keywords: Degenerative disease; Lumbar spine surgery; Mindfulness-based stress reduction; Patient-reported outcomes; Prescription opioids.

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