Pre-Treatment of Depression Prior to Cervical Spine Surgery Improves Patients' Perception of Post-operative Health Status: A retrospective Single Institutional Experience.

Pre-Treatment of Depression Prior to Cervical Spine Surgery Improves Patients' Perception of Post-operative Health Status: A retrospective Single Institutional Experience.

World Neurosurg. 2015 Dec 16;

Authors: Elsamadicy AA, Adogwa O, Cheng J, Bagley C

Abstract
BACKGROUND: Previous research has indicated that postoperative pain and functional outcomes are influenced by affective disorders, especially depression. The aim of this retrospective analysis is to assess whether pre-treatment of depression prior to surgery improved patient reported outcomes measures and overall satisfaction with care.
METHODS: 140 adult patients (Pre-Treated patients: 25, Control patients: 115) underwent Anterior Cervical Discectomy and Fusion at Duke University Medical Center were included in this study. Of the 140 patients, 25 patients had a known history of depression diagnosed and treated by a board certified psychiatrist with an antidepressant at least 6 months prior to surgery. Enrollment criteria included available demographic, surgical, medication and clinical outcome data. Patients completed the Neck Disability Index (NDI), Short-Form 12 (SF-12) and Visual Analog Pain Scale (VAS) before surgery, then at 3, 6, 12, and 24- months after surgery. Clinical outcomes were compared between both patient cohorts.
RESULTS: Baseline characteristics were similar between both cohorts, Table 1. At baseline there were no significant differences in NDI (p=0.11), SF-12 PCS (p=0.63), and VAS-neck pain (p=0.80), Table 2. There were no significant differences in the incidence of nerve root injury (p=0.00) or durotomy (p=0.31) between the treatment and control cohorts, Table 3. At 1-year post-operatively, both cohorts demonstrated similar improvement in VAS-neck pain (p=0.92), NDI (p=0.32), SF-12 PCS (p=0.15) and SF-12 MCS (p=0.38), Table 4. These results were durable through 2-years. At 2-year, both the demonstrated similar improvement from baseline in VAS-neck pain (p=0.88), NDI (p=0.43), SF-12 PCS (p=0.28) and SF-12 MCS (p=0.40), Figure 1.results CONCLUSION: Our study suggests that in patients with depression, pre-treatment with antidepressants prior to surgery significantly improves their perception and pain and functional disability.

PMID: 26706296 [PubMed - as supplied by publisher]

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