Impact of Preoperative Depression on Postoperative Pain Relief and Functional Outcomes Following Microlumbar Discectomy

Background: Lumbar disk herniation (LDH) is a major cause of chronic back pain (BP) and leg pain (LP), leading to disability and reduced quality of life. Microlumbar discectomy (MLD) is the standard surgical treatment for patients who fail conservative therapy. Depression commonly coexists with chronic BP and may adversely affect surgical outcomes. This study assessed pain relief, disability, and mental health following MLD. Materials and Methods: A prospective observational study was conducted on 23 patients (aged 18–70 years) with LDH undergoing MLD at a tertiary care center. Pain was assessed using the visual analog scale (VAS) for back pain (BP-VAS) and leg pain (LP-VAS), disability using the Oswestry Disability Index (ODI), and depression using a Modified Zung Self-Rating Depression Scale (excluding somatic items). Assessments were recorded preoperatively, immediately postoperatively, at 2 weeks, and at 3 months. Results: Preoperatively, 13 patients (56.5%) were at risk for depression, 3 (13.0%) had distressed depression, and 4 (17.4%) were normal. At 3 months, 22 patients (95.6%) were normal, with 1 remaining distressed. Mean ODI improved from 30.04 ± 9.07 to 8.87 ± 6.17 ( P < 0.001). Mean BP-VAS reduced from 7.87 ± 2.18 to 1.00 ± 1.80, and LP-VAS reduced from 8.22 ± 1.65 to 1.26 ± 1.83 (both P < 0.001). Depression scores also decreased significantly (24.26 ± 10.56 to 4.91 ± 4.67, P < 0.001). Conclusion: MLD significantly improves pain, disability, and mental health. Preoperative depression negatively influences outcomes, highlighting the importance of psychiatric evaluation and intervention perioperatively.