Approximately 30% of patients who undergo spinal surgery for chronic back pain continue to experience significant pain and disability up to 2 months following surgery. Prior studies have identified mental health variables including depression and anxiety as predictors of poorer postsurgical outcomes using screening instruments, but no studies have examined long-term outcomes using the Minnesota Multiphasic Personality Inventory-3 (MMPI-3), a commonly used tool used in presurgical psychological evaluations (PPE). Using group-based trajectory modeling and a sample of 404 spine surgery evaluees, the present study examined the trajectories of changes in disability scores from presurgery through 3, 12, and 24 months postsurgery. We then compared scores on MMPI-3 scales between trajectory groups. We identified three trajectory groups of change in disability over time: a rapid-remitting group (8%), characterized by moderate presurgical disability that rapidly and substantially remitted by 12 and 24 months; a steady-recovering group (68%), characterized by moderate presurgical disability, slower change over time, and mild levels of disability at the 2-year time point; and a persisting disability group (24%), characterized by severe presurgical disability that continued into long-term follow-ups. Participants in the persisting pain group produced higher presurgical scores on somatic/cognitive and internalizing MMPI-3 scales than participants in the rapid-remitting and steady-recovering groups. Our results support the clinical utility of the MMPI-3 in PPEs and highlight the importance of evaluating somatic/cognitive concerns and internalizing dysfunction to identify patients who are likely to have poorer postsurgical outcomes. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

中文翻译：

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脊柱手术恢复过程中术前 MMPI-3 评分的差异。


大约 30% 因慢性背痛而接受脊柱手术的患者在术后 2 个月内仍会出现严重疼痛和残疾。先前的研究已经使用筛查仪器确定了包括抑郁和焦虑在内的心理健康变量作为较差术后结果的预测因子，但没有研究使用明尼苏达多相人格量表 3 (MMPI-3)（一种常用工具）检查长期结果。术前心理评估（PPE）。本研究使用基于群体的轨迹模型和 404 名脊柱手术评估者样本，检查了从术前到术后 3、12 和 24 个月的残疾评分变化轨迹。然后我们比较了轨迹组之间 MMPI-3 量表的分数。我们确定了残疾随时间变化的三个轨迹组：快速缓解组（8%），其特点是中度术前残疾，在 12 个月和 24 个月内迅速且大幅缓解；稳定恢复组（68%），其特点是术前有中度残疾，随着时间的推移变化较慢，并且在 2 年时间点有轻度残疾；持续性残疾组（24%），其特点是严重的术前残疾并持续到长期随访中。持续性疼痛组的参与者在躯体/认知和内化 MMPI-3 量表上的术前评分高于快速缓解组和稳定恢复组的参与者。我们的结果支持 MMPI-3 在 PPE 中的临床实用性，并强调评估躯体/认知问题和内化功能障碍的重要性，以识别可能具有较差术后结果的患者。 （PsycInfo 数据库记录 (c) 2024 APA，保留所有权利）。