Are Outcomes of Anterior Cervical Discectomy and Fusion Influenced by Presurgical Depression Symptoms on the Mental Component Score of the Short Form-12 Survey?

Publication/Presentation Date

2-1-2020

Abstract

STUDY DESIGN: Retrospective comparative study.

OBJECTIVE: The purpose of this study was to investigate whether preoperative depressive symptoms, measured by mental component score of the Short Form-12 survey (MCS-12), influence patient-reported outcome measurements (PROMs) following an anterior cervical discectomy and fusion (ACDF) surgery for cervical degeneration.

SUMMARY OF BACKGROUND DATA: There is a paucity of literature regarding preoperative depression and PROMs following ACDF surgery for cervical degenerative disease.

METHODS: Patients who underwent an ACDF for degenerative cervical pathology were identified. A score of 45.6 on the MCS-12 was used as the threshold for depression symptoms, and patients were divided into two groups based on this value: depression (MCS-12 ≤45.6) and nondepression (MCS-12 >45.6) groups. Outcomes including Neck Disability Index (NDI), physical component score of the Short Form-12 survey (PCS-12), and Visual Analogue Scale Neck (VAS Neck), and Arm (VAS Arm) pain scores were evaluated using independent sample t test, recovery ratios, percentage of patients reaching the minimum clinically important difference, and multiple linear regression - controlling for factors such as age, sex, and BMI.

RESULTS: The depression group was found to have significantly worse baseline pain and disability than the nondepression group in NDI (P <  0.001), VAS Neck pain (P <  0.001), and VAS Arm pain (P <  0.001) scores. Postoperatively, both groups improved to a similar amount with surgery based on the recovery ratio analysis. The depression group continued to have worse scores than the nondepression group in NDI (P = 0.010), PCS-12 (P = 0.026), and VAS Arm pain (P = 0.001) scores. Depression was not a significant predictor of change in any PROMs based on regression analysis.

CONCLUSION: Patients who presented with preoperative depression reported more pain and disability symptoms preoperatively and postoperatively; however, both groups achieved similar degrees of improvement.

LEVEL OF EVIDENCE: 3.

Volume

45

Issue

3

First Page

201

Last Page

207

ISSN

1528-1159

Disciplines

Business Administration, Management, and Operations | Health and Medical Administration | Management Sciences and Quantitative Methods

PubMedID

31513106

Department(s)

Administration and Leadership

Document Type

Article

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