History of Prior Lumbar Surgery Does Not Impact Mental Health Outcomes Following Anterior Cervical Discectomy and Fusion. Issue 9 (7th November 2022)

• Record Type: Journal Article
• Authors: Geoghegan, Cara E.; Jadczak, Caroline N.; Jacob, Kevin C.; Patel, Madhav R.; Cha, Elliot D.K.; Lynch, Conor P.; Mohan, Shruthi; Singh, Kern
• Is Part Of: Clinical spine surgery. Volume 35:Issue 9(2022)
• Page Start: E737
• Page End: E742
• Publication Date: 2022-11-07
• Subjects: depression -- Patient Health Questionnaire 9=PHQ-9 -- cervical fusion -- lumbar spine -- physical health; Spinal cord -- Diseases -- Periodicals; Spinal cord -- Surgery -- Periodicals; 617.56059
• DOI: 10.1097/BSD.0000000000001355
• Languages: English
• ISSNs: 2380-0186

Abstract

Abstract : Study Design: This was a retrospective cohort study. Objective: The objective of this study was to evaluate the impact of undergoing a prior lumbar procedure on mental health outcomes following anterior cervical discectomy and fusion. Summary of Background Data: Revision and reoperations are perceived as risk factors for worse mental health outcomes. Methods: A retrospective review of a surgical database was performed for cervical and lumbar procedures. The mental health measures used were: Short Form 12-Item Mental Composite Score (SF-12 MCS) and Patient Health Questionnaire 9 (PHQ-9). Secondary outcomes of interest were Visual Analogue Scale for neck and arm pain, Neck Disability Index, and Short Form 12-Item Physical Composite Score (SF-12 PCS). All outcomes were collected preoperatively and at 6 weeks, 12 weeks, 6 months, and 1 year postoperatively. Minimum clinically important difference (MCID) was calculated using established values. Patients were grouped based on the surgical history of an elective lumbar spine procedure and propensity-matched. Differences in postoperative outcome scores and MCID achievement were evaluated using linear and logistic regression respectively. Results: A total of 74 patients were included in this study. Mental health outcomes did not demonstrate significant differences between groups for SF-12 MCS and PHQ-9 for all time points except at 6 weeks for PHQ-9 ( P =0.038). MCID achievement was not significantly impacted by surgical history for all outcome measures at all postoperative time points (all P >0.050). The majority of patients achieved an MCID by the 1-year time point for all outcomes for patients without a prior lumbar surgery except for Visual Analogue Scale arm and SF-12 PCS, while those with a surgical history achieved an MCID for all outcomes except SF-12 PCS and PHQ-9. Conclusions: Anterior cervical discectomy and fusion patients with a past history of lumbar surgery demonstrated significant improvements in depression, neck and arm pain, disability, and physical function as those without a past lumbar surgical history. Prior surgery also did not impact MCID achievement for all outcomes.