Anxiety symptom and relationship to pain, functional disability and quality of life among spinal deformity patients scheduled for surgery: a prospective cross-sectional study

Purpose To assess the prevalence, severity and association of anxiety symptom with pain, disability and quality of life (QoL) in spinal deformity diseases (SDD) patients, and to compared with common degenerative spinal diseases (DSD). Methods A total of 304 patients scheduled for spinal surgery were included in the analysis, of which 184 patients were diagnosed as various SDD and 120 were common DSD. HRQoL assessment included VAS, ODI and SF-12v2. The State-Trait Anxiety Inventory (STAI) was used to evaluated anxiety symptom. The SDD were further divided into two subgroups according to symptom severity: mildly symptomatic spinal deformity (NSSD) with VAS ≤ 3 and ODI ≤ 20; significantly symptomatic spinal deformity (SSSD) with VAS > 3 or ODI > 20. Bivariate correlation analysis was conducted by spearman correlation. Hierarchical regression analysis was further performed for QoL of SDD. Results The high anxiety symptom accounted for 68.3%, 51.2% and 49.2%, respectively in the SSSD, MSSD and DSD patients (p = 0.009). The SSSD had significantly higher scores of STAI-S, STAI-T and STAI-Total compared to the DSD, and significantly higher STAI-S than MSSD. Anxiety severity showed significantly positive correlations with VAS and ODI as well as negative correlations with MCS, PCS and SF-12 total scores. Age, educational level, financial burden, disability and trait-anxiety symptoms were independently associated with the QoL of SDD patients. Conclusions Psychosocial factors were important correlates of QoL in spinal deformity patients and a broader biopsychosocial view is necessary in the treatment of spinal deformity patients.