Abstract
BACKGROUND: Lumbar interbody fusion (LIF) is the primary treatment for lumbar degenerative diseases. Elderly patients are prone to anxiety and depression after undergoing surgery, which affects their postoperative recovery speed and quality of life. Effective prevention of anxiety and depression in elderly patients has become an urgent problem. AIM: To investigate the trajectory of anxiety and depression levels in elderly patients after LIF, and the influencing factors. METHODS: Random sampling was used to select 239 elderly patients who underwent LIF from January 2020 to December 2024 in Shenzhen Pingle Orthopedic Hospital. General information and surgery-related indices were recorded, and participants completed measures of psychological status, lumbar spine dysfunction, and quality of life. A latent class growth model was used to analyze the post-LIF trajectory of anxiety and depression levels, and unordered multi-categorical logistic regression was used to analyze the influencing factors. RESULTS: Three trajectories of change in anxiety level were identified: Increasing anxiety (n = 26, 10.88%), decreasing anxiety (n = 27, 11.30%), and stable anxiety (n = 186, 77.82%). Likewise, three trajectories of change in depression level were identified: Increasing depression (n = 30, 12.55%), decreasing depression (n = 26, 10.88%), and stable depression (n = 183, 76.57%). Regression analysis showed that having no partner, female sex, elevated Oswestry dysfunction index (ODI) scores, and reduced 36-Item Short Form Health Survey scores all contributed to increased anxiety levels, whereas female sex, postoperative opioid use, and elevated ODI scores all contributed to increased depression levels. CONCLUSION: During clinical observation, combining factors to predict anxiety and depression in post-LIF elderly patients enables timely intervention, quickens recovery, and enhances quality of life.