학술논문

Are Outcomes of Anterior Cervical Discectomy and Fusion Influenced by Presurgical Depression Symptoms on the Mental Component Score of the Short Form-12 Survey?
Document Type
Journal Article
Source
Spine (03622436). 2/1/2020, Vol. 45 Issue 3, p201-207. 7p.
Subject
*CERVICAL vertebrae
*NECK pain
*SPINAL fusion
*PREOPERATIVE period
*SURGICAL complications
*RETROSPECTIVE studies
*DISCECTOMY
*TREATMENT effectiveness
*MENTAL depression
*QUESTIONNAIRES
Language
ISSN
0362-2436
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. [ABSTRACT FROM AUTHOR]