Does fear impede the success of spinal surgery in patients with chronic Back pain? Potential prognosticative factors in spinal surgery failure

Abstract

One of the challenges in pain management is that many spine surgeries do not alleviate the pain in patients with chronic back pain (CBP). For Patients suffering from CBP, constant, persistent and relapsing pain overtime as a result of undergoing several surgeries main point of concentration will be on pain-related stimuli and develop pain-related fears. To show how fundamental fears can affect the outcome of the surgery. To assess fundamental fears (death anxiety, fear of pain (FOP), and Kinesiophobia) in CBP patients before undergoing spinal surgery. Patients [n\xa0=\u2009273] of Erfan Hospital had experienced persistent back pain for six months. One week before the operation, we administered the Tampa Scale for Kinesiophobia [Tampa], Fear of Pain Questionnaire-Short Form, Templer Death Anxiety Scale [DAS], and The McGill Pain Questionnaire. One week after the operation, we re-administrated only the McGill questionnaire and conducted multiple regressions to determine how fundamental fears can predict surgery failure concerning pain outcome. Intense fear of death, pain, or movement raised the probability of failure and decreased the postoperative pain [fear of death: T\u2009=\u20093.77, P\xa0<\u20090.001; FOP: T\u2009=\u20094.63, P\u2009<\u20090.001; Kinesiophobia: T\u2009=\u20093.88, P\u2009<\u20090.001]. Furthermore, results showed that death anxiety 18%, FOP 30%, and fear of movement 45% could predict surgery failure concerning pain sedation. Moreover, correlational coefficients between variables revealed the following indices respectively: FOP: r\u2009=\u20090.067, Kinesiophobia: r\u2009=\u2009−0.53, and death-related anxiety: r\u2009=\u20090.39 (all variables significant: Sig\u2009=\u20090.001). Initial fears such as fear of death, pain, and movement may lower the chance of surgery success. Hypervigilance, intrusive thoughts about death, avoidance behaviors (such as inactivity induced by Kinesiophobia) and obsessing over physical symptoms may cause spinal surgery’s failure in CBP patients. Ultimately, we provide future research suggestions and practical approaches to address these fears.