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

Srikanth N. Divi, Dhruv K.C. Goyal*, John J. Mangan, Matthew S. Galetta, Kristen J. Nicholson, Taolin Fang, Sourabh Goyal, Thomas J. Booth, Daniel Tarazona, Christopher Lucasti, I. David Kaye, Mark F. Kurd, Barrett I. Woods, Kris E. Radcliff, Jeffery A. Rihn, D. Greg Anderson, Alan S. Hilibrand, Christopher K. Kepler, Alexander R. Vaccaro, Gregory D. Schroeder

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

1 Scopus citations

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.

Original languageEnglish (US)
Pages (from-to)201-207
Number of pages7
JournalSpine
Volume45
Issue number3
DOIs
StatePublished - Feb 1 2020
Externally publishedYes

Keywords

  • 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

ASJC Scopus subject areas

  • Orthopedics and Sports Medicine
  • Clinical Neurology

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