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) - Divi, Srikanth N.
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 .