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08.08.2023 | Original Article

The influence of peri-operative depressive symptoms on medium-term spine surgery outcome: a prospective study

verfasst von: Pablo Bellosta-López, Filippo Mandelli, Francesco Langella, Marco Brayda-Bruno, Roberto Bassani, Riccardo Cecchinato, Domenico Compagnone, Fabrizio Giudici, Andrea Luca, Carlotta Morselli, Laura Scaramuzzo, Daniele Vanni, Matteo Ponzo, Pedro Berjano

Erschienen in: European Spine Journal | Ausgabe 10/2023

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Abstract

Purpose

To investigate the role of depressive symptoms on clinical outcomes in patients undergoing spinal surgery up to 2-year follow-up.

Methods

The study used data from an institutional spine surgery registry (January 2016, through March 2022) to identify patients (> 18 years) undergoing spine surgery. Patients with Oswestry Disability Index (ODI) < 20/100 at baseline or undergoing surgery on the cervical spine or for idiopathic spinal deformity and trauma patients were excluded. The patients were divided into two groups based on the pre-operative Mental Component Summary (MCS) score of the SF-36: depression group (MCS ≤ 35) or non-depression group (MCS > 35). The ODI and MCS scores trajectory were wined over the 24-month post-surgery between groups. Additionally, a secondary subgroup analysis was conducted comparing outcomes between those with depressive symptoms (persistent-depression subgroup) and those without depressive symptoms (never-depression subgroup) at 3 months after surgery.

Results

A total of 2164 patients who underwent spine surgery were included. The pre-operative depression group reported higher ODI total scores and lower MCS than the pre-operative non-depression group at all time points (P < 0.001). The persistent-depression subgroup reported higher ODI total scores and lower MCS than the never-depression subgroup at all follow-ups (P < 0.001).

Conclusion

Functional disability and mental health status improve in patients with depression symptoms undergoing spinal surgery. Despite this improvement, they do not reach the values of non-depressed subjects. Over the 2-year follow-up time, patients with depression show a different trajectory of ODI and MCS. Caregivers should be aware of these results to counsel patients with depression symptoms.

Cieza A, Causey K, Kamenov K et al (2021) Global estimates of the need for rehabilitation based on the global burden of disease study 2019: a systematic analysis for the global burden of disease study 2019. Lancet (London, England) 396:2006–2017. https://doi.org/10.1016/S0140-6736(20)32340-0CrossRefPubMed

Foster NE, Anema JR, Cherkin D et al (2018) Prevention and treatment of low back pain: evidence, challenges, and promising directions. Lancet (London, England) 391:2368–2383. https://doi.org/10.1016/S0140-6736(18)30489-6CrossRefPubMed

Mannion AF, Fekete TF, Porchet F et al (2014) The influence of comorbidity on the risks and benefits of spine surgery for degenerative lumbar disorders. Eur spine J Off Publ Eur Spine Soc Eur Spinal Deform Soc Eur Sect Cerv Spine Res Soc 23(Suppl 1):S66-71. https://doi.org/10.1007/s00586-014-3189-yCrossRef

Wong JJ, Tricco AC, Côté P et al (2022) Association between depressive symptoms or depression and health outcomes for low back pain: a systematic review and meta-analysis. J Gen Intern Med 37

Chen Z, Luo R, Yang Y, Xiang Z (2021) The prevalence of depression in degenerative spine disease patients: A systematic review and meta-analysis. Eur Spine J 30

Block AR (2016) Demoralization, patient activation, and the outcome of spine surgery. Healthc (Basel, Switz). https://doi.org/10.3390/healthcare4010011CrossRef

Berjano P, Langella F, Ventriglia L et al (2021) The influence of baseline clinical status and surgical strategy on early good to excellent result in spinal lumbar arthrodesis: a machine learning approach. J Pers Med. https://doi.org/10.3390/jpm11121377CrossRefPubMedPubMedCentral

Ware JE, Sherbourne CD (1992) The MOS 36-item short-form health survey (Sf-36): I. Conceptual framework and item selection. Med Care. https://doi.org/10.1097/00005650-199206000-00002CrossRefPubMed

Walsh TL, Homa K, Hanscom B et al (2006) Screening for depressive symptoms in patients with chronic spinal pain using the SF-36 health survey. Spine J. https://doi.org/10.1016/j.spinee.2005.11.004CrossRefPubMed

10.

Cushnie D, Soroceanu A, Stratton A et al (2022) Outcome of spine surgery in patients with depressed mental states: a Canadian spine outcome research network study. Spine J. https://doi.org/10.1016/j.spinee.2022.05.012CrossRefPubMed

11.

Stull JD, Divi SN, Goyal DKC et al (2020) Preoperative mental health component scoring is related to patient reported outcomes following lumbar fusion. Spine (Phila Pa 1976) 45:798–803. https://doi.org/10.1097/BRS.0000000000003399CrossRefPubMed

12.

Adogwa O, Parker SL, Shau DN et al (2013) The impact of preoperative depression on quality of life outcomes after posterior cervical fusion. Spine J 13:501–506. https://doi.org/10.1016/j.spinee.2014.07.001CrossRefPubMed

13.

Bakhsheshian J, Scheer JK, Gum JL et al (2017) Impact of poor mental health in adult spinal deformity patients with poor physical function: a retrospective analysis with a 2-year follow-up. J Neurosurg Spine. https://doi.org/10.3171/2016.5.SPINE151428CrossRefPubMed

14.

Theologis AA, Ailon T, Scheer JK et al (2016) Impact of preoperative depression on 2-year clinical outcomes following adult spinal deformity surgery: the importance of risk stratification based on type of psychological distress. J Neurosurg Spine. https://doi.org/10.3171/2016.2.SPINE15980CrossRefPubMed

15.

Asher R, Mason AE, Weiner J, Fessler RG (2015) The relationship between preoperative general mental health and postoperative quality of life in minimally invasive lumbar spine surgery. Neurosurgery. https://doi.org/10.1227/NEU.0000000000000695CrossRefPubMed

16.

Langella F, Barletta P, Baroncini A et al (2021) The use of electronic PROMs provides same outcomes as paper version in a spine surgery registry. Results from a prospective cohort study. Eur Spine J 30:2645–2653. https://doi.org/10.1007/s00586-021-06834-zCrossRefPubMed

17.

Fairbank JC, Couper J, Davies JB, O’Brien JP (1980) The Oswestry low back pain disability questionnaire. Physiotherapy 66:271–273PubMed

18.

Fairbank JC, Pynsent PB (2000) The Oswestry disability index. Spine (Phila Pa 1976) 25:2940–52; discussion 2952. https://doi.org/10.1097/00007632-200011150-00017

19.

Mongin D, Lauper K, Turesson C et al (2019) Imputing missing data of function and disease activity in rheumatoid arthritis registers: what is the best technique? RMD Open. https://doi.org/10.1136/rmdopen-2019-000994CrossRefPubMedPubMedCentral

20.

Cohen J (2013) Statistical power analysis for the behavioral sciences

21.

Lafage R, Ang B, Schwab F et al (2021) Depression symptoms are associated with poor functional status among operative spinal deformity patients. Spine (Phila Pa 1976). https://doi.org/10.1097/BRS.0000000000003886CrossRefPubMed

22.

Gill SC, Butterworth P, Rodgers B, Mackinnon A (2007) Validity of the mental health component scale of the 12-item short-form health survey (MCS-12) as measure of common mental disorders in the general population. Psychiatry Res. https://doi.org/10.1016/j.psychres.2006.11.005CrossRefPubMed

23.

Gornet MF, Copay AG, Schranck FW, Kopjar B (2015) Observational study of depression in patients undergoing cervical disc arthroplasty: evidence of a correlation between pain relief and resolution of depression. Int J Spine Surg. https://doi.org/10.14444/3011CrossRef

24.

Akobeng AK (2008) Confidence intervals and p-values in clinical decision making. Acta Paediatr Int J Paediatr 97

25.

American Psychiatric Association (2022) Diagnostic and statistical manual of mental disorders, Fifth Edition, Text Revision. Angew Chemie Int Ed 6(11), 951–952

26.

Power JD, Kudesia P, Nadeem A et al (2019) Patterns of depressive symptoms before and after surgery for osteoarthritis: a descriptive study. ACR Open Rheumatol. https://doi.org/10.1002/ACR2.1031CrossRefPubMedPubMedCentral

Titel: The influence of peri-operative depressive symptoms on medium-term spine surgery outcome: a prospective study
verfasst von: Pablo Bellosta-López
Filippo Mandelli
Francesco Langella
Marco Brayda-Bruno
Roberto Bassani
Riccardo Cecchinato
Domenico Compagnone
Fabrizio Giudici
Andrea Luca
Carlotta Morselli
Laura Scaramuzzo
Daniele Vanni
Matteo Ponzo
Pedro Berjano
Publikationsdatum: 08.08.2023
Verlag: Springer Berlin Heidelberg
Erschienen in: European Spine Journal / Ausgabe 10/2023
Print ISSN: 0940-6719
Elektronische ISSN: 1432-0932
DOI: https://doi.org/10.1007/s00586-023-07875-2

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The influence of peri-operative depressive symptoms on medium-term spine surgery outcome: a prospective study