Purpose: The purpose of the study was to investigate the trajectory and determinants of changes in health-related quality of life (HRQoL) in the first year after lumbar spine surgery. Methods: A total of 154 consecutive patients who underwent lumbar spine surgery were included in this prospective longitudinal observational study. All participants were asked to complete a battery of questionnaires (Taiwanese version of World Health Organization Quality of Life-BREF, Numerical Rating Scale for leg and back pain, Mandarin Chinese version of the Clinically Useful Depression Outcome Scale, and Chinese version of the Pittsburgh Sleep Quality Index). The Japanese Orthopedic Association score was evaluated by neurosurgeons. The measurement time points were 1 week before and on the first, sixth, and twelfth month after lumbar spinal surgery. A linear mix model was used for data analyses. Results: The analyses revealed significant upward trends in HRQoL, particularly in physical health and social relationships during the study period. Patients who aged < 65 years and reported a higher level of functional status experienced a more favorable HRQoL in physical health over time (p =.002 and.02, respectively). Participants who complained of poor sleep quality yielded poorer HRQoL in physical health over time (p =.03). More severe depressive symptom was associated with the poorer HRQoL in social relationships over time (p <.001). Conclusions: To improve the HRQoL, healthcare providers need to pay attention to changes in sleep quality, neurological functions, and depressive symptoms in people receiving lumbar surgery, particularly individuals with increasing age. Concrete interventions and strategies aimed to enhancing HRQoL in these patients are essential.
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