Effect of surgical treatment on mental health, disability and quality of life in active military and law enforcement personnel with non-specific chronic low back pain: A retrospective study

Abstract

Background

Military and law enforcement personnel face an increased risk of chronic low back pain (CLBP), yet evidence on the outcomes of surgical treatment in these high-risk groups remains limited. This study aims to evaluate the effect of spinal fusion on quality of life (QOL), disability, and mental health in military and law enforcement personnel with CLBP.

Methods

The study included 39 patients who underwent spinal fusion for CLBP. Quality of life, disability, and mental health were assessed using the 36-Item Short Form Survey (SF-36), Oswestry Disability Index (ODI), and Depression-Anxiety-Stress Scale (DASS-21), respectively. Patients completed the questionnaires preoperatively and two years postoperatively. The primary outcome was the change in scores after surgery. Subgroup analyses were conducted based on sex, marital status, education level, smoking, alcohol consumption, and employment sector.

Results

Significant improvements were observed in seven of eight SF-36 subscales: Physical Health Role Limitation (p = 0.005), Emotional Health Role Limitation (p = 0.008), Energy (p = 0.004), Emotional Well-Being (p = 0.006), Social Function (p = 0.004), Physical Pain (p < 0.001), and General Health (p = 0.005). Physical (p = 0.002) and mental health components (p = 0.002) also improved. ODI decreased significantly (p = 0.014). Finally, improvement was observed only for the stress subcategory of the DASS-21 (p = 0.033). In subgroup analysis, Married patients showed greater improvements in emotional health (p = 0.008), while patients with lower educational levels experienced greater relief in physical pain (p = 0.028) and functionality (p = 0.010).

Conclusions

Spinal fusion in military and law enforcement personnel with CLBP led to significant improvements in QOL and disability, though mental health benefits are more limited.