Abstract
BACKGROUND CONTEXT: Spine patients have a higher rate of depression then the general population which may be caused in part by levels of pain and disability from their spinal disease. PURPOSE: Determination whether improvements in health-related quality of life (HRQOL) resulting from successful spine surgery leads to improvements in mental health. STUDY DESIGN/SETTING: The Canadian Spine Outcome Research Network prospective surgical outcome registry. OUTCOME MEASURES: Change between preoperative and postoperative SF12 Mental Component Score (MCS). Secondary outcomes include European Quality of Life (EuroQoL) Healthstate, SF-12 Physical Component Score (PCS), Oswestry Disability Index (ODI), Patient Health Questionaire-9 (PHQ9), and pain scales. METHODS: The Canadian Spine Outcome Research Network registry was queried for all patients receiving surgery for degenerative thoracolumbar spine disease. Exclusion criteria were trauma, tumor, infection, and previous spine surgery. SF12 Mental Component Scores (MCS) were compared between those with and without significant improvement in postoperative disability (ODI) and secondary measures. Multivariate analysis examined factors predictive of MCS improvement. RESULTS: Eighteen hospitals contributed 3222 eligible patients. Worse ODI, EuroQoL, PCS, back pain and leg pain correlated with worse MCS at all time points. Overall, patients had an improvement in MCS that occurred within 3 months of surgery and was still present 24 months after surgery. Patients exceeding Minimally Clinically Important Differences in ODI had the greatest improvements in MCS. Major depression prevalence decreased up to 48% following surgery, depending on spine diagnosis. CONCLUSIONS: Large scale, real world, registry data suggests that successful surgery for degenerative lumbar disease is associated with reduction in the prevalence of major depression regardless of the specific underlaying diagnosis. Worse baseline MCS was associated with worse baseline HRQOL and improved postoperatively with coincident improvement in disability, emphasizing that mental wellness is not a static state but may improve with well-planned spine surgery.
Original language | English |
---|---|
Pages (from-to) | 1332-1339 |
Number of pages | 8 |
Journal | Spine Journal |
Volume | 21 |
Issue number | 8 |
DOIs | |
Publication status | Published - Aug 2021 |
Bibliographical note
Funding Information:Author disclosures: DC: Nothing to disclose. CF: Royalities: Medtronic (amount not disclosed); Consulting: Medtronic, Nuvasive (amount not disclosed); Grants: OREF (amount not disclosed); Fellowship Support: Medtronic, AO Spine (amount not disclosed). HH: Nothing to disclose. MJ: Research Support (Investigator Salary): Stryker (F). SC: Consulting: Medtronic Canada (amount not disclosed); Grants: Medtronic Canada, Rick Hansen Institute (amount not disclosed). CB: Research Support: Medtronic Canada (E, Paid directly to institution/employer). PP: Stryker research grant (F). EA: Consulting: Medtronic Canada (C); Grants: Medtronic Canada (F). AG: Grants: Medtronic (E). BJ: Stryker (F); Speaking/Teaching arrangements: Medtronic (B). JP: Grants: Medtronic of Canada (G). KT: Nothing to disclose.
Publisher Copyright:
© 2021 Elsevier Inc.
ASJC Scopus Subject Areas
- Surgery
- Orthopedics and Sports Medicine
- Clinical Neurology
PubMed: MeSH publication types
- Journal Article