The effect of different types of cortisol secretion on the prognosis of lumbar discectomy |
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| Authors: | Chong-Nan Yan Huan Wang Miao Peng Shao-Qian Cui Hai-Lun Gu |
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| Institution: | 1215. Spine and Trauma Orthopedic Ward, Shengjing Hospital affiliated to China Medical University, 110004, Shenyang, China
2215. Psychological Outpatient Service, Shengjing Hospital affiliated to China Medical University, 110004, Shenyang, China
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| Abstract: | Background The purpose of this study was to investigate saliva cortisol levels of Chinese patients with discogenic sciatica and to clarify the relationship between psychosocial factors and saliva cortisol levels. We also intended to elucidate the effect of different types of cortisol secretion on the prognosis of lumbar discectomy. Methodology 37 patients with discogenic sciatica, 18 patients with chronic somatic pain and 20 healthy pain-free subjects were included in this analysis. The Japanese Orthopedic Association (JOA) score was used to evaluate functional ability. The diurnal patterns of cortisol secretion of the three groups were assessed. The correlation between cortisol secretion level and preoperative psychosocial surveys was assessed. Results The patients with chronic somatic pain showed a significantly low level of cortisol secretion during the declining period and an obvious decline from the peak. The change in JOA score after surgery was positively correlated with saliva cortisol concentration during the peak period and the declining period, and negatively correlated with the magnitude of cortisol change throughout the day. Psychosocial factors were correlated with improved JOA scores. These factors are also interrelated to the cortisol secretion level. Conclusions Cortisol secretion level is a correlative physiological mechanism for the effect of psychosocial factors on the prognosis of lumbar discectomy. |
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