Skip to main content
SpringerLink
Log in

Somatic comorbidity and younger age are associated with life dissatisfaction among patients with lumbar spinal stenosis before surgical treatment

  • Review
  • Published:
European Spine Journal Aims and scope Submit manuscript

Abstract

The objective of the study was to examine self-reported life satisfaction and associated factors in patients (n=100) with lumbar spinal stenosis (LSS) in secondary care level, selected for surgical treatment. Life satisfaction was assessed with the four-item Life Satisfaction scale. Depression was assessed with a 21-item Beck Depression Inventory (BDI). Psychological well-being was assessed with Toronto Alexithymia Scale and Sense of Coherence Scale. LSS related physical functioning and pain were assessed with Oswestry disability index, Stucki questionnaire, Visual Analogue Scale and pain drawings. All questionnaires were administered before surgical treatment of LSS. Results showed that 25% of the patients with LSS were found to be dissatisfied with life. In a univariate analysis, smoking, elevated subjective disability scores and extensive markings in the pain drawings were more common in the dissatisfied patients. The dissatisfied patients also showed lower coping resources, elevated alexithymia and depression scores, and were more often depressed. In multiple logistic regression analyses, only younger age and somatic comorbidity were associated with life dissatisfaction. This association remained significant even when the BDI score was added into the model. No other significant associations emerged. In conclusion, life dissatisfaction was rather common among preoperative LSS patients. Pain and constraints on everyday functioning were important correlates of life dissatisfaction. However, only younger age and somatic comorbidity were independently associated with life dissatisfaction. These results emphasize the importance of recognizing and assessing the effect of coexisting medical conditions and they need to be addressed in any treatment program.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Allardt E (1973) About dimension of welfare: an explanatory analysis of the comparative Scandinavian survey. University of Helsinki, Finland, Research Group of Comparative Sociology Research Reports 1

  2. Antonovsky A (1981) Unraveling the mystery of health. Jossey Bass, San Francisco

    Google Scholar 

  3. Antovosky A (1993) The structure and properties of the sense of coherence scale. Soc Sci Med 36:725–733

    Article  Google Scholar 

  4. Bagby RM, Parker JDA, Taylor GJ (1994) The twenty-item Toronto Alexithymia Scale—I. Item-selection and cross-validation of the factor structure. J Psychosom Res 38:23–32

    Article  PubMed  CAS  Google Scholar 

  5. Bagby RM, Parker JDA, Taylor GJ (1994) The twenty-item Toronto Alexithymia Scale—II. Convergent, discriminant and concurrent validity. J Psychosom Res 38:33–40

    Article  PubMed  CAS  Google Scholar 

  6. Beck AT, Ward CH, Mendelson M, Mock J, Erbaugh J (1961) An inventory for measuring depression. Arch Gen Psychiatry 4:561–71

    PubMed  CAS  Google Scholar 

  7. Bowman BJ (1996) Cross-cultural validation of Antonosky’s sense of coherence scale. J Clin Psychol 52:547–549

    Article  PubMed  CAS  Google Scholar 

  8. Breek JC, Hamming JF, De Vries J, Van Berge Henegouwen DP, van Heck GL (2002) The impact of walking impairment, cardiovascular risk factors, and comorbidity on quality of life in patients with intermittent claudication. J Vasc Surg 36:94–99

    Article  PubMed  CAS  Google Scholar 

  9. Fairbank JCT, Pynsent PB (2000) The Oswestry disability index. Spine 25:2940–2953

    Article  PubMed  CAS  Google Scholar 

  10. Fairbank JCT, Davies JB, Couper J et al (1980) The Oswestry low back pain disability questionnaire. Physiotherapy 66:271–273

    PubMed  CAS  Google Scholar 

  11. Field D (1997) “Looking back, what period of your life brought you the most satisfaction?” Int J Aging Hum Dev 45:169–194

    Article  PubMed  CAS  Google Scholar 

  12. Flannery RB, Perry C, Penk WE, Flannery GJ (1994) Validating Antonovsky’s sense of coherence scale. J Clin Psychol 50:575–577

    Article  PubMed  Google Scholar 

  13. Galiano K, Obwegeser AA, Gabl MV, Bauer R, Twerdy K (2005) Long-term outcome of laminectomy for spinal stenosis in octogenarians. Spine 30:332–335

    Article  PubMed  Google Scholar 

  14. Grönblad M, Hupli M, Wennerstrand P, Järvinen E, Lukinmaa A, Kouri JP, Karaharju EO (1993) Intercorrelations and re-test reliability of the Pain Disability Index (PDI) and the Oswestry Disability Questionnaire (ODQ) and their correlation with pain intensity in low back pain patients. Clin J Pain 9:189–195

    Article  PubMed  Google Scholar 

  15. Headley BC, Kelley J, Wearing AJ (1993) Dimensions of mental health: life satisfaction, positive affect, anxiety and depression. Soc Indic Res 29:63–82

    Article  Google Scholar 

  16. Herno A, Saari T, Suomalainen O, Airaksinen O (1999) The degree of decompressive relief and its relation to clinical outcome in patients undergoing surgery for lumbar spinal stenosis. Spine 15:1010–1014

    Article  Google Scholar 

  17. Honkalampi K, Saarinen P, Hintikka J, Virtanen V, Viinamäki H (1999) Factors associated with alexithymia in patients suffering from depression. Psychother Psychosom 68:270–275

    Article  PubMed  CAS  Google Scholar 

  18. Horley J (1984) Life satisfaction, happiness and morale: two problems with the use of subjective well-being indicators. Gerontologist 24:124–127

    Article  PubMed  CAS  Google Scholar 

  19. Hornquist JO, Hansson B, Åkerlind I, Larsson J (1992) Severity of disease and quality of life: a comparison in patients with cancer and benign disease. Qual Life Res 1:135–141

    Article  PubMed  CAS  Google Scholar 

  20. Hurri H, Slätis P, Soini J, Tallroth K, Alaranta H, Laine T, Heliövaara M (1998) Lumbar spinal stenosis: assessment of long-term outcome 12 years after operative and conservative treatment. J Spinal Disord 11:110–115

    Article  PubMed  CAS  Google Scholar 

  21. Joukamaa M, Miettunen M, Kokkonen P, Koskinen M, Julkunen J, Kauhanen J, Jokelainen J, Veijola J, Läksy K, Järvelin MR (2001) Psychometric properties of the Finnish 20-item Toronto Alexithymia Scale. Nord J Psychiatry 55:123–127

    PubMed  CAS  Google Scholar 

  22. Kalimo R, Vuori J (1990) Work and sense of coherence—resources for competence and life satisfaction. Behav Med 16:76–89

    Article  PubMed  CAS  Google Scholar 

  23. Kaprio J, Koskenvuo M, Langinvainio H, Romanov K, Sarna S, Rose RJ (1987) Genetic influences on use and abuse of alcohol: a study of 5638 adult Finnish twin brothers. Alcohol Clin Exp Res 11:349–356

    Article  PubMed  CAS  Google Scholar 

  24. Katz JN, Lipson SJ, Lew RA, Grobler LJ, Weinstein JN, Brick GW, Fossel AH, Liang MH (1997) Lumbar laminectomy alone or with instrumented or noninstrumented arthrodesis in degenerative lumbar spinal stenosis. Patient selection, costs, and surgical outcomes. Spine 22:1123–1131

    Article  PubMed  CAS  Google Scholar 

  25. Kivimäki M, Feldt T, Vahtera J, Nurmi J (2000) Sense of coherence and health: evidence from two cross-lagged longitudinal samples. Soc Sci Med 50:583–97

    Article  PubMed  Google Scholar 

  26. Koivumaa-Honkanen H (1998) Life satisfaction as a health predictor. Kuopio University Publications D. Medical Sciences 143. Kuopio, Finland

  27. Koivumaa-Honkanen H, Viinamäki H, Honkanen R, Tanskanen A, Antikainen R, Niskanen L, Jääskeläinen J, Lehtonen J (1996) Correlates of life-satisfaction among psychiatric patients. Acta Psychiatr Scand 94:372–378

    PubMed  CAS  Google Scholar 

  28. Koivumaa-Honkanen H, Honkanen R, Antikainen R, Hintikka J, Viinamäki H (1999) Self-reported life satisfaction and treatment factors in patients with schizophrenia, major depression and anxiety disorder. Acta Psychiatr Scand 99:377–384

    PubMed  CAS  Google Scholar 

  29. Koivumaa-Honkanen H, Honkanen R, Viinamäki H, Heikkilä K, Kaprio J, Koskenvuo M (2000) Self-reported life satisfaction and 20-year mortality in healthy Finnish adults. Am J Epidemiol 152:983–991

    Article  PubMed  CAS  Google Scholar 

  30. Koivumaa-Honkanen H, Honkanen R, Viinamäki H, Heikkilä K, Kaprio J, Koskenvuo M (2001) Life satisfaction and suicide: a 20-year follow-up study. Am J Psychiatry 158:433–439

    Article  PubMed  CAS  Google Scholar 

  31. Koivumaa-Honkanen H, Honkanen R, Koskenvuo M, Viinamäki H, Kaprio J (2002) Life satisfaction as a predictor of fatal injury in a 20-year follow-up. Acta Psychiatr Scand 105:444–450

    Article  PubMed  CAS  Google Scholar 

  32. Koivumaa-Honkanen H, Kaprio J, Honkanen R, Viinamäki H, Koskenvuo M (2004) Life satisfaction and depression in a 15-year follow-up of healthy adults. Soc Psychiatry Psychiatr Epidemiol 39:994–999

    Article  PubMed  Google Scholar 

  33. Koivumaa-Honkanen H, Kaprio J, Honkanen R, Viinamäki H, Koskenvuo M (2005) The stability of life satisfaction in a 15-year follow-up of adult Finns healthy at baseline. BMC Psychiatry 5:4

    Article  PubMed  Google Scholar 

  34. Korkeila M, Kaprio J, Rissanen A, Koskenvuo M, Sorensen TI (1998) Predictors of major weight gain in adult Finns: stress, life-satisfaction and personality traits. Int J Obes 22:949–957

    Article  CAS  Google Scholar 

  35. Kunzman U, Little TD, Smith J (2000) Is age-related stability of subjective well-being a paradox? Cross-sectional and longitudinal evidence from the Berlin Aging Study. Psychol Aging 15:511–526

    Article  Google Scholar 

  36. Margolis RB, Tait RC, Krause SJ (1986) Rating system for use with patient pain drawings. Pain 24:57–65

    Article  PubMed  CAS  Google Scholar 

  37. Mossey JM, Shapiro E (1982) Self-rated health: a predictor of mortality among the elderly. Am J Public Health 72:800–808

    Article  PubMed  CAS  Google Scholar 

  38. Nilsson B, Holmgren L, Westman G (2000) Sense of coherence in different stages of health and disease in northern Sweden. Gender and psychosocial differences. Scand J Prim Health Care 18:14–20

    Article  PubMed  CAS  Google Scholar 

  39. Nilsson B, Holmgren L, Stegmayr B, Westman G (2003) Sense of coherence-stability over time and relation to health, disease, and psychosocial changes in a general population: a longitudinal study. Scand J Public Health 31:297–304

    Article  PubMed  Google Scholar 

  40. Price DD, McGrath PA, Rafii A, Buckingham B (1983) The validation of visual analogue scales as ratio scale measures for chronic and experimental pain. Pain 17:45–56

    Article  PubMed  CAS  Google Scholar 

  41. Rausching W (1993) Pathoanatomy of lumbar disc degeneration and stenosis. Acta Orthop Scand 64(Suppl 251):3–11

    Google Scholar 

  42. Rillardon L, Guigui P, Veil-Picard A, Slulittel H, Deburge A (2003) Long-term results of surgical treatment of lumbar spinal stenosis. Rev Chir Orthop Reparatrice Appar Mot 89:621–631

    PubMed  CAS  Google Scholar 

  43. Robinson-Whelen S, Bodenheimer C (2004) Health practices of veterans with unilateral lower-limb loss: identifying correlates. J Rehabil Res Dev 41:453–460

    Article  PubMed  Google Scholar 

  44. Schillberg M, Nystrom B (2000) Quality of life before and after microsurgical decompression in lumbar spinal stenosis. J Spinal Disord 13:237–241

    Article  PubMed  CAS  Google Scholar 

  45. Schneider G, Driesch G, Kruse A, Wachter M, Nehen HG, Heuft G (2004) What influences self-perception of health in the elderly? The role of objective health condition, subjective well-being and sense of coherence. Arch Gerontol Geriatr 39:227–237

    Article  PubMed  Google Scholar 

  46. Sifneos P (1972) Short-term psychotherapy and emotional crises. Harvard University Press, Cambridge

    Google Scholar 

  47. Stucki G (1996) Measurement properties of a self-administered outcome measure in lumbar spinal stenosis. Spine 21:796–803

    Article  PubMed  CAS  Google Scholar 

  48. Suominen S, Helenius H, Blomberg H, Uutela A, Koskenvuo M (2001) Sense of coherence as a predictor of subjective state of health. Results of 4 years follow-up of adults. J Psychosom Res 50:77–86

    Article  PubMed  CAS  Google Scholar 

  49. Tanskanen A, Hintikka J, Honkalampi K, Haatainen K, Koivumaa-Honkanen H, Viinamäki H (2004) Impact of multiple traumatic experiences on the persistence of depressive symptoms. A population-based study. Nord J Psychiatry 58:459–464

    Article  PubMed  Google Scholar 

  50. Taylor GJ, Bagby RM, Parker JDA (1997) Disorders of affect regulation. Cambridge University Press, Cambridge, pp 60–66

    Google Scholar 

  51. Tuomi K, Ilmarinen J, Jahkola A, Katajarinne L, Tulkki A (1998) An approved version of the Work Ability Index. Occupational health—series 19. Finnish Institute of Occupational Health, Helsinki

  52. Valkamo M, Hintikka J, Honkalampi K, Niskanen L, Koivumaa-Honkanen L, Viinamäki H (2001) Alexithymia in patients with coronary heart disease. J Psychosom Res 50:125–140

    Article  PubMed  CAS  Google Scholar 

  53. Valkamo M, Koivumaa-Honkanen H, Hintikka J, Niskanen L, Honkalampi L, Viinamäki H (2003) Life satisfaction in patients with chest pain subsequently diagnosed as coronary heart disease—connection through depressive symptoms? Qual Life Res 12:1099–1105

    Article  PubMed  CAS  Google Scholar 

  54. Verbiest H (1954) A radicular syndrome from developmental narrowing of the lumbar vertebral canal. J Bone Joint Surg Br 36:230–237

    PubMed  Google Scholar 

  55. Viinamäki H, Tanskanen A, Honkalampi K, Koivumaa-Honkanen HT, Haatainen K, Kaustio O, Hintikka J (2004) Is the Beck Depression Inventory suitable for screening major depression in different phases of the disease? Nord J Psychiatry 58:49–53

    Article  PubMed  Google Scholar 

Download references

Acknowledgements

We thank Ewen MacDonald (University of Kuopio, Department of Pharmacology and Toxicology) for language checking. S. Sinikallio wishes to thank the Finnish Cultural Foundation for financial support. T. Aalto wishes to thank docent Jaakko Rinne, the Head of the Department of Neurosugery in Kuopio University Hospital for co-ordination in the recruitment phase of the study. The study design was reviewed and approved by the Ethics Committee of University of Kuopio and Kuopio University Hospital, Finland and experiments were in compliance with Finnish law.

Author information

Authors and Affiliations

  1. Department of Rehabilitation, Kuopio University Hospital, Kuopio, Finland

    Sanna Sinikallio

  2. Department of Surgery, Kuopio University, Kuopio, Finland

    Timo Aalto

  3. Department of Physical Medicine and Rehabilitation, Kuopio University Hospital, Kuopio, Finland

    Timo Aalto, Olavi Airaksinen & Arto Herno

  4. Department of Surgery/Orthopaedics, Kuopio University Hospital, Kuopio, Finland

    Heikki Kröger

  5. Department of Neurosurgery, Kuopio University Hospital, Kuopio, Finland

    Heikki Kröger & Sakari Savolainen

  6. Department of Surgery/Orthopaedics, Kuopio University Hospital, Kuopio, Finland

    Veli Turunen

  7. Department of Psychiatry, Kuopio University and Kuopio University Hospital, Kuopio, Finland

    Heimo Viinamäki

Authors
  1. Sanna Sinikallio
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Timo Aalto
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Olavi Airaksinen
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Arto Herno
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Heikki Kröger
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Sakari Savolainen
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Veli Turunen
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Heimo Viinamäki
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Sanna Sinikallio.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Sinikallio, S., Aalto, T., Airaksinen, O. et al. Somatic comorbidity and younger age are associated with life dissatisfaction among patients with lumbar spinal stenosis before surgical treatment. Eur Spine J 16, 857–864 (2007). https://doi.org/10.1007/s00586-006-0080-5

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00586-006-0080-5

Keywords

Search

Navigation