Does grit and self-control impact outcomes following spine surgery? Early findings from a prospective study evaluating the association between grit and self-control following minimally invasive laminectomy/microdiscectomy and anterior cervical surgery.

Abstract

Psychological traits such as grit and self-control are increasingly recognized for their potential role in influencing recovery across various medical disciplines. However, their relationship with outcomes following spine surgery remains largely unexplored. To evaluate whether grit and self-control are associated with postoperative outcomes in patients undergoing common cervical or lumbar spine surgery for degenerative conditions. Prospective observational study conducted at a single academic spine center. A total of 150 patients were included: 47 patients underwent anterior cervical discectomy and fusion (ACDF) or cervical disc replacement (CDR), and 103 patients underwent lumbar laminectomy or microdiscectomy (MCD). Patient-reported outcomes included the Oswestry Disability Index (ODI), Neck Disability Index (NDI), and Visual Analog Scale (VAS) for back, leg, neck, and arm pain. Grit and self-control were assessed using the Short Grit Scale (GRIT-S) and a 10-item Self-Control (SC) questionnaire. Patients completed GRIT-S and SC assessments preoperatively. Clinical outcomes (ODI, NDI, and VAS) were collected at baseline and at 6 weeks, 3 months, 6 months, and 1 year postoperatively. Spearman correlation was used to examine associations between grit, self-control, and surgical outcomes, analyzed separately for cervical and lumbar cohorts. In lumbar surgery patients, no significant correlations were observed between GRIT-S or SC scores and ODI or VAS scores at any timepoint. In cervical surgery patients, GRIT-S scores were associated with VAS neck scores at 6 weeks (r = 0.31, p = 0.03) and 3 months (r = 0.52, p < 0.001), and with VAS arm scores at 1 year (r = 0.41, p = 0.004). SC scores correlated negatively with NDI at 6 months (r = -0.32, p= 0.04). No consistent associations were found across all timepoints. Although grit and self-control were not associated with recovery after lumbar surgery, select associations in cervical patients suggest these traits may influence perceived pain and disability at certain postoperative intervals. However, the overall lack of consistent correlation indicates a limited predictive role, and further research is warranted to clarify their influence on spine surgery outcomes.