A Validation of Patient Health Questionnaire-9 for Cervical Spine Surgery. Issue 23 (1st December 2020)

• Record Type: Journal Article
• Authors: Parrish, James M.; Jenkins, Nathaniel W.; Nolte, Michael T.; Massel, Dustin H.; Hrynewycz, Nadia M.; Brundage, Thomas S.; Singh, Kern
• Is Part Of: Spine. Volume 45:Issue 23(2020)
• Publication Date: 2020-12-01
• Subjects: anterior cervical discectomy and fusion -- cervical disc replacement -- Patient Health Questionnaire–9 -- 12-Item Short Form Health Survey -- Veterans RAND 12 Item Health Survey; Spine -- Abnormalities -- Periodicals; Spine -- Diseases -- Periodicals; Spine -- Surgery -- Periodicals; 616.73005
• DOI: 10.1097/BRS.0000000000003644
• Languages: English
• ISSNs: 0362-2436

Abstract

Abstract : Study Design: Retrospective. Objective: The purpose of this study is to evaluate depressive symptoms as measured by the PHQ-9 survey and correlated them with scores from the SF-12 and VR-12 Mental Component Summary (MCS). Summary of Background Data: With the rising incidence of depression and the need to identify modifiable risk factors before surgery, it is increasingly important to screen for preoperative depressive symptoms in spine surgery. Although the Patient Health Questionnaire-9 (PHQ-9) has favorable characteristics as a depressive symptom screening instrument, it has not been evaluated within cervical spine surgery. Methods: A prospectively maintained surgical registry was reviewed for patients undergoing single or multilevel anterior cervical discectomy and fusion (ACDF) or cervical disc replacement (CDR) from March 2016 until May 2019. Included patients underwent a procedure for degenerative spinal pathology. We collected demographic, baseline, and perioperative variables. The mean scores for postoperative PHQ-9, Short Form-12 (SF-12), and Veterans RAND-12 (VR-12) surveys were calculated, and an average change between preoperative and postoperative scores. Scatterplots depicted the association of SF-12 MCS and VR-12 MCS with PHQ-9. We evaluated the relationship of PHQ-9 with SF-12 MCS and VR-12 MCS scores by calculating a Pearson correlation coefficient and time-independent partial correlation coefficient. Results: One hundred fifty-two patients underwent single or multilevel level cervical spine surgery (ACDF: 73% and CDR: 27%). The average age was 42.4 and 39% were female. Compared to preoperative scores, significant increases were observed among postoperative PHQ-9, SF-12, and VR-12 MCS surveys ( P ⩽ 0.001). We observed strong correlations between SF-12 and VR-12 MCS with PHQ-9 scores for both assessed correlations. Conclusion: Patients undergoing ACDF or CDR demonstrated significant improvement with PHQ-9, SF-12 MCS, and VR-12 MCS instruments. PHQ-9 scores strongly correlated with SF-12 MCS and VR-12 MCS. Our findings indicate PHQ-9 is a valid tool to evaluate pre and postsurgical depressive symptoms. Level of Evidence: 4 Abstract : We assessed patients undergoing anterior cervical discectomy and fusion and cervical disc replacement and validated the Patient Health Questionnaire 9. We observed strong pre- and postoperative PHQ-9 score correlations with legacy metrics including Short Form-12, and Veterans RAND-12 mental component scores.