PMID- 32250973
OWN - NLM
STAT- MEDLINE
DCOM- 20211025
LR  - 20211025
IS  - 2380-0194 (Electronic)
IS  - 2380-0186 (Linking)
VI  - 33
IP  - 10
DP  - 2020 Dec
TI  - Are Preoperative PHQ-9 Scores Predictive of Postoperative Outcomes Following 
      Anterior Cervical Discectomy and Fusion?
PG  - E486-E492
LID - 10.1097/BSD.0000000000000985 [doi]
AB  - STUDY DESIGN: This is a retrospective study. OBJECTIVE: The objective of this 
      study was to determine if there is an association between preoperative 
      depression, as quantified by Patient Health Questionnaire-9 (PHQ-9), and 
      postoperative improvement in pain and disability after anterior cervical 
      discectomy and fusion (ACDF). SUMMARY OF BACKGROUND DATA: Few studies have 
      quantified depression symptoms in the preoperative period using PHQ-9 and have 
      tracked patient-reported outcomes (PROs) following ACDF. METHODS: Patients 
      undergoing ACDF were retrospectively reviewed and stratified by their 
      preoperative PHQ-9 score. PROs, including Neck Disability Index (NDI), Visual 
      Analogue Scale (VAS) neck and arm pain, and 12-Item Short Form (SF-12) Physical 
      Component Score (PCS), were measured preoperatively and at 6-week, 3-month, 
      6-month, and 1-year postoperatively. PRO scores were analyzed amongst PHQ-9 
      cohorts using multiple linear regression. Achievement of minimum clinically 
      important difference (MCID) was compared using chi analysis. RESULTS: Higher PHQ-9 
      scores were associated with increased preoperative NDI, VAS neck, and VAS arm 
      scores and significantly lower SF-12 PCS scores preoperatively. Cohorts 
      experienced similar VAS pain scores up to 1-year following surgery, except for 
      VAS neck pain at 3 months when patients with greater depression symptoms had more 
      pain. High PHQ-9 patients had higher NDI values at 6 weeks and 3-month marks but 
      had similar NDI scores at 6 months and 1-year. Similarly, SF-12 PCS scores were 
      lower for patients with a higher PHQ-9 score at 3 and 6 months, however, both 
      groups had similar scores at 1-year follow-up. A greater percentage of the high 
      PHQ-9 cohort achieved MCID for NDI, however, there were no differences in MCID 
      achievement for VAS neck, VAS arm, or SF-12 PCS. CONCLUSIONS: Patients with worse 
      preoperative mental health reported significantly greater preoperative disability 
      and pain. However, both cohorts demonstrated similar clinical recovery at the 
      1-year follow-up. These findings suggest patients with worse preoperative mental 
      health can expect significant improvements in PROs following surgery.
FAU - Jenkins, Nathaniel W
AU  - Jenkins NW
AD  - Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL.
FAU - Parrish, James M
AU  - Parrish JM
FAU - Yoo, Joon S
AU  - Yoo JS
FAU - Patel, Dillon S
AU  - Patel DS
FAU - Hrynewycz, Nadia M
AU  - Hrynewycz NM
FAU - Brundage, Thomas S
AU  - Brundage TS
FAU - Singh, Kern
AU  - Singh K
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Clin Spine Surg
JT  - Clinical spine surgery
JID - 101675083
SB  - IM
MH  - Cervical Vertebrae/surgery
MH  - Diskectomy
MH  - Humans
MH  - Neck Pain/etiology/surgery
MH  - *Patient Health Questionnaire
MH  - Retrospective Studies
MH  - *Spinal Fusion
MH  - Treatment Outcome
EDAT- 2020/04/07 06:00
MHDA- 2021/10/26 06:00
CRDT- 2020/04/07 06:00
PHST- 2020/04/07 06:00 [pubmed]
PHST- 2021/10/26 06:00 [medline]
PHST- 2020/04/07 06:00 [entrez]
AID - 01933606-202012000-00014 [pii]
AID - 10.1097/BSD.0000000000000985 [doi]
PST - ppublish
SO  - Clin Spine Surg. 2020 Dec;33(10):E486-E492. doi: 10.1097/BSD.0000000000000985.