Published online May 19, 2026. doi: 10.5498/wjp.v16.i5.113948
Revised: December 4, 2025
Accepted: February 2, 2026
Published online: May 19, 2026
Processing time: 197 Days and 0.2 Hours
Anxiety and depression are common perioperative emotional disorders in patients undergoing endoscopic spine surgery for lumbar degenerative diseases (LDDs) and may hinder optimal clinical recovery.
To examine perioperative anxiety and depression in endoscopic spine surgery-managed LDD patients and explored how these emotional disturbances relate to resilience.
A total of 167 patients with LDD treated surgically between February 2021 and February 2024 were enrolled. Anxiety and depression were evaluated using the Zung Self-Rating Anxiety Scale (SAS) and Self-Rating Depression Scale (SDS), respectively, on the preoperative day (day 1), postoperative day 7, and 6 months post-surgery. Resilience was assessed preoperatively with the Connor-Davidson Resilience Scale (CD-RISC). Associations between preoperative emotional distress and resilience were analyzed, and determinants of resilience among clinically anxious or depressive patients were identified using univariate and multivariate regression.
SAS and SDS scores decreased significantly after surgery. The mean preoperative CD-RISC score was 64.26 ± 8.16, with 27.54% classified as having low resilience. Preoperative SAS and SDS values showed significant inverse correlations with CD-RISC. Patients with anxiety or depression had markedly lower CD-RISC scores at baseline, and those with depression exhibited persistently reduced resilience at day 7 and 6 months. Social support, household monthly income per capita, and preoperative SAS/SDS scores independently predicted resilience.
Perioperative anxiety and depression are prevalent in LDD patients, peak preoperatively, and improve by postoperative day 7 and at 6 months. Resilience appears protective, given its inverse association with emotional distress. Social support, family income, and preoperative anxiety/depression severity serve as key resilience predictors.
Core Tip: This study shows that perioperative endoscopic spine surgery patients with lumbar degenerative diseases commonly experience anxiety and depression, with the greatest severity occurring preoperatively and improving after surgery. Preoperative anxiety and depression were closely linked to resilience, although these associations weakened postoperatively over time. Higher levels of preoperative emotional distress also limited social support, and lower family income increased the likelihood of reduced resilience. These findings support incorporating resilience assessment and targeted social support interventions into routine perioperative management to promote simultaneous physical and psychological recovery in patients with lumbar degenerative disease.