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Research ArticleCervical Spine

The Effect of Preoperative Mental Health Status on Outcomes After Anterior Cervical Discectomy and Fusion

Donald F. Colantonio, Ahmad Nassr, Brett A. Freedman, Benjamin D. Elder, Mohamad Bydon, Melvin D. Helgeson, Christopher K. Kepler, Arjun S. Sebastian and Scott C. Wagner
International Journal of Spine Surgery April 2022, 16 (2) 233-239; DOI: https://doi.org/10.14444/8211
Donald F. Colantonio
1 Department of Orthopaedic Surgery, Walter Reed National Military Medical Center, Bethesda, MD, USA
2 Department of Surgery, Uniformed Services University of the Health Sciences, Bethesda, MD, USA
MD
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Ahmad Nassr
3 Department of Orthopaedic Surgery, Mayo Clinic, Rochester, MN, USA
MD
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Brett A. Freedman
3 Department of Orthopaedic Surgery, Mayo Clinic, Rochester, MN, USA
MD
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Benjamin D. Elder
4 Department of Neurosurgery, Mayo Clinic, Rochester, MN, USA
MD, PhD
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Mohamad Bydon
4 Department of Neurosurgery, Mayo Clinic, Rochester, MN, USA
MD
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Melvin D. Helgeson
1 Department of Orthopaedic Surgery, Walter Reed National Military Medical Center, Bethesda, MD, USA
2 Department of Surgery, Uniformed Services University of the Health Sciences, Bethesda, MD, USA
MD
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Christopher K. Kepler
5 Rothman Orthopaedic Institute at Thomas Jefferson University, Philadelphia, PA, USA
MD, MBA
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Arjun S. Sebastian
3 Department of Orthopaedic Surgery, Mayo Clinic, Rochester, MN, USA
MD
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Scott C. Wagner
1 Department of Orthopaedic Surgery, Walter Reed National Military Medical Center, Bethesda, MD, USA
2 Department of Surgery, Uniformed Services University of the Health Sciences, Bethesda, MD, USA
MD
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    Table 1

    Demographics and preoperative data for the depressed and nondepressed groups.

    CharacteristicDepression Cohort (n = 23)Nondepression Cohort (n = 49)P
    Age, y, mean48.453.20.062
    Sex, female)52.2%46.9%0.802
    BMI, mean31.130.10.673
    Comorbidities
     Diabetes13.0%24.5%0.358
     Hypertension26.1%53.1% 0.043
     Hyperlipidemia13.0%51.0% 0.002
     Rheumatologic disorder17.4%16.3%0.786
     Alcohol abuse13.0%10.2%0.721
     Tobacco abuse13.0%8.2%0.515
    ACDF
     1-level47.8%40.8%0.575
     2-level43.5%38.8%0.704
     3-level8.7%20.4%0.315
    • Data presented as % unless otherwise noted. Boldface indicates statistically significant findings.

    • ACDF, anterior cervical discectomy and fusion; BMI, body mass index.

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    Table 2

    Mean scores on the patient-reported mental health measures (RAND and EQ-5D) and pain intensity (NDI), with comparisons before and after teh operation.

    Mean
    Outcome MeasurePreoperativePostoperativeΔP
    RAND: MCS overall68.7977.498.70 0.0001
    EQ-5D: MHD overall1.731.450.28 0.01
    Pain intensity (NDI) overall2.081.041.18 <0.0001
    • Boldface indicates statistically significant findings.

    • EQ-5D, EuroQol 5-dimension; MCS, Mental Composite Score; MHD, mental health domain; NDI, Neck Disability Index.

    • View popup
    Table 3

    Results of the patient-reported mental health measures (RAND and EQ-5D) and pain intensity (NDI), with comparisons between depressed and nondepressed groups, as well as within both groups before and after the operation.

    Outcome MeasureDepression Cohort (n = 23)Nondepression Cohort (n = 49)P
    RAND
     MCS preoperative48.3478.56 <0.0001
     MCS postoperative66.7882.63 <0.001
     Mean Δ8.704.04 0.001
     P 0.0001 0.04
    EQ-5D
     MHD preoperative2.391.4 <0.0001
     MHD postoperative1.781.3 0.01
     Mean Δ0.600.125 0.04
     P 0.01 0.28
    Pain
     Preoperative2.31.980.17
     Postoperative1.040.830.34
     Mean Δ1.261.150.70
     P 0.001 <0.0001
    • Boldface indicates statistically significant findings.

    • EQ-5D, EuroQol 5-dimension; MCS, Mental Composite Score; MHD, mental health domain; NDI, Neck Disability Index.

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International Journal of Spine Surgery
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1 Apr 2022
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The Effect of Preoperative Mental Health Status on Outcomes After Anterior Cervical Discectomy and Fusion
Donald F. Colantonio, Ahmad Nassr, Brett A. Freedman, Benjamin D. Elder, Mohamad Bydon, Melvin D. Helgeson, Christopher K. Kepler, Arjun S. Sebastian, Scott C. Wagner
International Journal of Spine Surgery Apr 2022, 16 (2) 233-239; DOI: 10.14444/8211

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The Effect of Preoperative Mental Health Status on Outcomes After Anterior Cervical Discectomy and Fusion
Donald F. Colantonio, Ahmad Nassr, Brett A. Freedman, Benjamin D. Elder, Mohamad Bydon, Melvin D. Helgeson, Christopher K. Kepler, Arjun S. Sebastian, Scott C. Wagner
International Journal of Spine Surgery Apr 2022, 16 (2) 233-239; DOI: 10.14444/8211
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