Although depressive symptoms are common among those living with back pain, there is limited information
on the relationship between postsurgical pain reduction and changes in depressive symptoms. The
objective of this prospective cohort study was to examine the change in pain and depressive symptoms
and to characterize the relationship between pain and depressive symptoms after lumbar spine surgery.
We assessed 260 individuals undergoing lumbar spine surgery preoperatively and postoperatively (3 and
6 months) using a pain intensity numeric rating scale and the Patient Health Questionnaire depression
scale. The relationship between change in pain (a 2-point decrease or 30% reduction from the preoperative
level) and depressive symptoms was examined using standard regression methods. Preoperatively,
the mean pain intensity was 5.2 (SD 2.4) points, and the mean depressive symptom score was 5.03
(SD 2.44) points. At 3 months, individuals who experienced a reduction in pain (63%) were no more likely
to experience a reduction in depressive symptoms (odds ratio 1.07, 95% confidence interval [CI] .58 to
1.98) than individuals who experienced no change from preoperative pain (34%). However, at 6 months,
individuals who experienced a reduction in pain (63%) were nearly twice as likely to experience a reduction
in depressive symptoms (odds ratio 1.93, 95% CI 1.15 to 3.25) as those who experienced no change or
an increase in pain (31%). We found that most individuals experienced clinically important reductions in
pain after surgery. We concluded that those whose pain level was reduced at 6 months were more likely
to experience a reduction in depressive symptoms.