Depression Identified on the Mental Component Score of the Short Form-12 Affects Health Related Quality of Life after Lumbar Decompression Surgery

Srikanth N. Divi, Dhruv K.C. Goyal*, Justin D. Stull, Monica Morgenstern, Matthew S. Galetta, I. David Kaye, Mark F. Kurd, Barrett I. Woods, Kris E. Radcliff, Jeffery A. Rihn, David 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


Study Design: This was a retrospective comparative study. Objective: The goal of this study was to further elucidate the relationship between preoperative depression and patient-reported outcome measurements (PROMs) following lumbar decompression surgery. Summary of Background Data: The impact of preoperative depression on PROMs after lumbar decompression surgery is not well established. Methods: Patients undergoing lumbar decompression between 1 and 3 levels were retrospectively identified. Patients were split into 2 groups using a preoperative Mental Component Score (MCS)-12 threshold score of 45.6 or 35.0 to identify those with and without depressive symptoms. In addition, patients were also split based on a pre-existing diagnosis of depression in the medical chart. Absolute PROM scores, the recovery ratio and the percent of patients achieving minimum clinically important difference between groups were compared, and a multiple linear regression analysis was performed. Results: A total of 184 patients were included, with 125 (67.9%) in the MCS-12 >45.6 group and 59 (32.1%) in the MCS-12 =45.6 group. The MCS-12 =45.6 and MCS<35.0 group had worse baseline Oswestry Disability Index (ODI) (P<0.001 for both) and Visual Analogue Scale Leg (P=0.018 and 0.024, respectively) scores. The MCS =45.6 group had greater disability postoperatively in terms of SF-12 Physical Component Score (PCS-12) (39.1 vs. 43.1, P=0.015) and ODI (26.6 vs. 17.8, P=0.006). Using regression analysis, having a baseline MCS-12 scores =45.6 before surgical intervention was a significant predictor of worse improvement in terms of PCS-12 [ß=-4.548 (-7.567 to -1.530), P=0.003] and ODI [ß=8.234 (1.433, 15.035), P=0.010] scores than the MCS-12 >45.6 group. Conclusion: Although all patients showed improved in all PROMs after surgery, those with MCS-12 =45.6 showed less improvement in PCS-12 and ODI scores.

Original languageEnglish (US)
Pages (from-to)E126-E132
JournalClinical spine surgery
Issue number3
StatePublished - Apr 2021
Externally publishedYes


  • depression
  • lumbar decompression
  • Oswestry Disability Index
  • patient-reported outcome measurements
  • SF-12 Mental Component Score
  • SF-12 Physical Component Score
  • Visual Analogue Scale Back pain
  • Visual Analogue Scale Leg pain

ASJC Scopus subject areas

  • Surgery
  • Orthopedics and Sports Medicine
  • Clinical Neurology


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