Are Outcomes of Anterior Cervical Discectomy and Fusion Influenced by Presurgical Depression Symptoms on the Mental Component Score of the Short Form-12 Survey?. Issue 3 (1st February 2020)

• Record Type: Journal Article
• Authors: Divi, Srikanth N.; Goyal, Dhruv K.C.; Mangan, John J.; Galetta, Matthew S.; Nicholson, Kristen J.; Fang, Taolin; Goyal, Sourabh; Booth, Thomas J.; Tarazona, Daniel; Lucasti, Christopher; Kaye, I. David; Kurd, Mark F.; Woods, Barrett I.; Radcliff, Kris E.; Rihn, Jeffery A.; Anderson, D. Greg; Hilibrand, Alan S.; Kepler, Christopher K.; Vaccaro, Alexander R.; Schroeder, Gregory D.
• Is Part Of: Spine. Volume 45:Issue 3(2020)
• Publication Date: 2020-02-01
• Subjects: anterior cervical discectomy and fusion -- anxiety -- cervical degenerative disease -- depression -- mental component score -- neck disability index -- patient-reported outcome measures -- physical component score -- short form-12 -- VAS arm -- VAS neck -- visual analogue score; Spine -- Abnormalities -- Periodicals; Spine -- Diseases -- Periodicals; Spine -- Surgery -- Periodicals; 616.73005
• DOI: 10.1097/BRS.0000000000003231
• Languages: English
• ISSNs: 0362-2436

Abstract

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 Abstract : A retrospective comparative study was conducted to determine whether preoperative depressive symptoms, measured by mental component score of the Short Form-12 survey, influences patient-reported outcomes following an anterior cervical discectomy and fusion for cervical degenerative pathology. Depression was not a significant predictor of outcome changes over time, despite baseline and postoperative differences between depressed and nondepressed groups in various patient-reported outcome measurements .