Delay in Seeking Surgical Treatment of Spondylolisthesis and Factors Influencing Functional Recovery after Lumbar Fusion
| Autor: | Heng-Fei Wu, 鄔恒斐 |
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| Rok vydání: | 2014 |
| Druh dokumentu: | 學位論文 ; thesis |
| Popis: | 102 Posterior lumbar decompression and fusion is the primary surgical treatment for patients with severe spondylolisthesis, and patients can have great improvement in physical function after the surgery. However, concerns regarding complications of the surgery often hindered patients from receiving the indicated surgery in time and this delay may have negative impacts on patients’ recovery. This study aimed to investigate spondylolisthesis patients’: (1) delay in seeking medical treatment, (2) delay in receiving surgerying, (3) factors influencing preoperative disability, and (4) factors influencing function recovery after lunbar fusion. The study is a longitudinal descriptive correlational design. Eighty six spondylolisthesis patients underwent the posterior lumbar decompression and fusions were recruited from a medical center in northern Taiwan. The data were collected by using the study questionnaires before surgery, one, three and six months after surgery. The questionnaires included delay in seeking medical treatment questionnaire, Oswestry disability index 2.1, revised geriatric depression scale- short form and pain numeric rating scale. The data were analyzed using descriptive statistics, independent sample t-test, ANOVA, Pearson correlation, liner regression and generalized estimating equation. The average time for delay in seeking medical treatment and delay in receiving surgery was 29.16 and 23.71 months, respectively. The participants’ mean disability indexes were 48.52, 40.73, 28.67 and 18.19 measured at baseline, one month, three months, and six months post operation, respectively. Low back pain, depression, age and gender were the significant predictors of the preoperative disability. These four variables together explained 40.9% of the variation of the disability severity. Age, gender, delay in receiving surgery, and low back pain were significant covariates for the changes of disability severity across time. Patients with spondylolisthesis should be actively treated for lower back pain and depression. Special attention should be paid to female patients. For those who have a higher risk for delay in seeking surgical treatment, we should provide relevant medical information, track whether they seek treatment or not, and encourage them to accept recommended surgery as soon as possible, in order to have a better outcomes on recovery. |
| Databáze: | Networked Digital Library of Theses & Dissertations |
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