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

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.