RT Journal Article
SR Electronic
T1 The Effect of Preoperative Mental Health Status on Outcomes After Anterior Cervical Discectomy and Fusion
JF International Journal of Spine Surgery
JO Int J Spine Surg
FD International Society for the Advancement of Spine Surgery
SP 233
OP 239
DO 10.14444/8211
VO 16
IS 2
A1 Donald F. Colantonio
A1 Ahmad Nassr
A1 Brett A. Freedman
A1 Benjamin D. Elder
A1 Mohamad Bydon
A1 Melvin D. Helgeson
A1 Christopher K. Kepler
A1 Arjun S. Sebastian
A1 Scott C. Wagner
YR 2022
UL http://ijssurgery.com//content/16/2/233.abstract
AB Background The effect of preoperative mental health on outcomes after anterior cervical discectomy and fusion (ACDF) is of increasing interest. The purpose of this study was to utilize patient-reported outcome measures (PROMs) to compare outcomes after ACDF in patients with and without poor mental health. We hypothesized that patients with worse baseline mental health would report worse outcomes after surgery.Methods Patients undergoing ACDF for degenerative cervical spondylosis with at least 12 months of follow-up were included. Outcomes collected before and after surgery included the RAND-36, Neck Disability Index (NDI), EuroQol 5-dimension (EQ-5D), and Single Assessment Numeric Evaluation (SANE) score.Results Seventy-one patients were included and assigned to the depression or nondepression group based on baseline mental health. The depression group had worse baseline preoperative scores across all PROMs: NDI (44.2 vs 36.8, P = 0.05), RAND (1511.4 vs 2198.18, P < 0.001), EQ-5D (12.55 vs 10.14, P < 0.001), and SANE (56.3 vs 72.9, P < 0.001). Postoperatively, the depression group had worse scores at the final follow-up for RAND (2242.8 vs 2662.2, P = 0.03) and SANE (71.5 vs 80.8, P = 0.02). Both groups experienced improvements with ACDF across all PROMs. The changes in each PROM were not statistically significant between groups. There were no statistically significant differences in the percentage of patients achieving the minimal clinically important difference across PROMs.Conclusion This study is the first to utilize the RAND-36, EQ-5D, NDI, and SANE scores to assess preoperative mental health and its effect on postoperative outcomes after ACDF. While poor preoperative mental health status yielded significantly worse baseline and postoperative outcomes scores, patients experienced significant improvement in symptoms after ACDF.Level of Evidence 2.Clinical Relevance Clinicians should be aware of the effects of poor mental health status on clinical outcomes in patients undergoing anterior cervical fusion, but can still expect significant clinical improvements after surgery.