PMID- 35835574
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20230112
IS  - 2211-4599 (Print)
IS  - 2211-4599 (Electronic)
IS  - 2211-4599 (Linking)
VI  - 16
IP  - 6
DP  - 2022 Dec
TI  - Anterior Cervical Discectomy and Fusion Results in Clinically Significant 
      Improvements in Patients With Preoperative Sleep Difficulties.
PG  - 1046-1053
LID - 10.14444/8333 [doi]
AB  - BACKGROUND: Individual items within the Patient Health Questionnaire-9 (PHQ-9) 
      have not been assessed as predictors of postoperative outcomes. Our objective is 
      to study the relationship between responses to individual PHQ-9 items and 
      achievement of a minimum clinically important difference (MCID) following 
      anterior cervical discectomy and fusion (ACDF). METHODS: A prospective surgical 
      database was reviewed for primary, single-level ACDF procedures performed for 
      degenerative spinal pathology. Patient demographics, preoperative spinal 
      pathology, and perioperative characteristics were recorded. Patient-reported 
      outcome measures (PROMs) including PHQ-9, visual analog scale (VAS) neck and arm, 
      Neck Disability Index, 12-item Short Form physical component score (SF-12 PCS), 
      and Patient-Reported Outcomes Measurement Information System Physical Function 
      were administered at preoperative and 6-week, 12-week, 6-month, 1-year, and 
      2-year postoperative timepoints. MCID achievement was determined by comparing 
      postoperative PROM improvement from baseline to previously established values. 
      Logistic regression assessed responses to each individual question of the 
      preoperative PHQ-9 as predictors of MCID achievement in each other PROMs. 
      RESULTS: Sixty-six ACDF patients were included with a mean age of 47.2 years. 
      Herniated nucleus pulposus was the most common preoperative spinal diagnosis 
      (95.6%). The mean operative duration was 50.3 minutes, the mean estimated blood 
      loss was 27.5 mL, and most patients were discharged on postoperative day 0 
      (81.8%). A majority of patients achieved MCID for all measures except SF-12 PCS. 
      PHQ-9 question 3 significantly predicted MCID achievement for VAS neck (P = 
      0.045), VAS arm (P = 0.049), and SF-12 PCS (P = 0.037). No other PHQ-9 items or 
      overall PHQ-9 scores significantly predicted MCID achievement. CONCLUSION: 
      Question 3 of the PHQ-9 regarding "trouble falling asleep, staying asleep, or 
      sleeping too much" significantly predicted clinically meaningful improvement in 
      neck pain, arm pain, and physical function following ACDF, although overall PHQ-9 
      scores did not. Providers should inform patients experiencing significant 
      sleep-related difficulties that they may be especially likely to benefit from 
      ACDF surgery. CLINICAL RELEVANCE: Evaluation of sleep from the PHQ-9 predicts 
      clinically relevant improvement in neck pain, arm pain, and physical function in 
      patients undergoing ACDF.
CI  - This manuscript is generously published free of charge by ISASS, the 
      International Society for the Advancement of Spine Surgery. Copyright (c) 2022 
      ISASS. To see more or order reprints or permissions, see http://ijssurgery.com.
FAU - Lynch, Conor P
AU  - Lynch CP
AD  - Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL, 
      USA.
FAU - Cha, Elliot D K
AU  - Cha EDK
AD  - Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL, 
      USA.
FAU - Patel, Madhav R
AU  - Patel MR
AD  - Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL, 
      USA.
FAU - Jacob, Kevin C
AU  - Jacob KC
AD  - Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL, 
      USA.
FAU - Mohan, Shruthi
AU  - Mohan S
AD  - Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL, 
      USA.
FAU - Geoghegan, Cara E
AU  - Geoghegan CE
AD  - Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL, 
      USA.
FAU - Jadczak, Caroline N
AU  - Jadczak CN
AD  - Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL, 
      USA.
FAU - Singh, Kern
AU  - Singh K
AD  - Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL, 
      USA kern.singh@rushortho.com.
LA  - eng
PT  - Journal Article
DEP - 20220714
PL  - Netherlands
TA  - Int J Spine Surg
JT  - International journal of spine surgery
JID - 101579005
PMC - PMC9807043
OTO - NOTNLM
OT  - anterior cervical discectomy and fusion (ACDF)
OT  - patient health questionnaire-9 (PHQ-9)
OT  - patient-reported outcome measures (PROMs)
EDAT- 2022/07/15 06:00
MHDA- 2022/07/15 06:01
PMCR- 2022/07/14
CRDT- 2022/07/14 21:43
PHST- 2022/07/15 06:00 [pubmed]
PHST- 2022/07/15 06:01 [medline]
PHST- 2022/07/14 21:43 [entrez]
PHST- 2022/07/14 00:00 [pmc-release]
AID - 8333 [pii]
AID - IJSSURGERY-D-21-00078 [pii]
AID - 10.14444/8333 [doi]
PST - ppublish
SO  - Int J Spine Surg. 2022 Dec;16(6):1046-1053. doi: 10.14444/8333. Epub 2022 Jul 14.