The impact of preoperative depression on quality of life outcomes after posterior cervical fusion

被引:54
作者
Alvin, Matthew D. [1 ,2 ]
Miller, Jacob A. [1 ,3 ]
Sundar, Swetha [1 ,2 ]
Lockwood, Megan [1 ,2 ]
Lubelski, Daniel [1 ,3 ]
Nowacki, Amy S. [3 ,4 ]
Scheman, Judith [1 ,5 ]
Mathews, Manu [5 ]
McGirt, Matthew J. [6 ]
Benzel, Edward C. [1 ,3 ,7 ]
Mroz, Thomas E. [1 ,3 ,7 ]
机构
[1] Cleveland Clin, Ctr Spine Hlth, Cleveland, OH 44195 USA
[2] Case Western Reserve Univ, Sch Med, Cleveland, OH 44106 USA
[3] Cleveland Clin, Lerner Coll Med, Cleveland, OH 44195 USA
[4] Cleveland Clin, Dept Quantitat Hlth Sci, Cleveland, OH 44195 USA
[5] Cleveland Clin, Neurol Ctr Pain, Cleveland, OH 44195 USA
[6] Carolina Neurosurg & Spine Associates, Charlotte, NC 28204 USA
[7] Cleveland Clin, Dept Neurol Surg, Cleveland, OH 44195 USA
关键词
PCF; PHQ-9; Depression; Outcomes; Cervical fusion; CSM; Myelopathy; REVISION LUMBAR SURGERY; SPONDYLOTIC MYELOPATHY; PREDICTIVE FACTORS; SURGICAL-TREATMENT; SPINAL STENOSIS; PRIME-MD; LAMINECTOMY; ANTERIOR; HEALTH; DECOMPRESSION;
D O I
10.1016/j.spinee.2014.07.001
中图分类号
R74 [神经病学与精神病学];
学科分类号
100204 [神经病学];
摘要
BACKGROUND CONTEXT: Posterior cervical fusion (PCF) has been shown to be an effective treatment for cervical spondylosis, but is associated with a 9% complication rate and high costs. To limit such complications and costs, it is imperative that proper selection of surgical candidates occur for those most likely to do well with the surgery. Affective disorders, such as depression, are associated with worsened outcomes after lumbar surgery; however, this effect has not been evaluated in patients undergoing cervical spine surgery. PURPOSE: To assess the predictive value of preoperative depression and the health state on 1-year quality of life (QOL) outcomes after PCF. STUDY DESIGN: A retrospective cohort analysis. PATIENT SAMPLE: Eighty-eight patients who underwent PCF for cervical spondylosis were reviewed. OUTCOME MEASURES: Preoperative and 1-year postoperative health outcomes were assessed based on the Pain Disability Questionnaire (PDQ), the Patient Health Questionnaire-9 (PHQ-9), and the EuroQol five-dimensions (EQ-5D) questionnaire. METHODS: Univariable and multivariable regression analyses were performed to assess for preoperative predictors of 1-year change in health status. RESULTS: Compared with preoperative health states, the PCF cohort showed statistically significant improved PDQ (87.8 vs. 73.6), PHQ-9 (7.7 vs. 6.6), and EQ-5D (0.50 vs. 0.60) scores at 1 year postoperatively. Only 10/88 (11%) patients achieved or surpassed the minimum clinically important difference for the PHQ-9 (5). Multiple linear and logistic regression analyses showed that increasing PHQ-9 and EQ-5D preoperative scores were associated with reduced 1-year postoperative improvement in health status (EQ-5D index). CONCLUSIONS: Of patients who undergo PCF, those with a greater degree of preoperative depression have lower improvements in postoperative QOL compared with those with less depression. Additionally, patients with better preoperative health states also attain lower 1-year QOL improvements. (C) 2015 Elsevier Inc. All rights reserved.
引用
收藏
页码:79 / 85
页数:7
相关论文
共 34 条
[1]
Preoperative predictors for postoperative clinical outcome in lumbar spinal stenosis -: Systematic review [J].
Aalto, Timo J. ;
Malmivaara, Antti ;
Kovacs, Francisco ;
Herno, Arto ;
Alen, Markku ;
Salmi, Liisa ;
Kroger, Heikki ;
Andrade, Juan ;
Jimenez, Rosa ;
Tapaninaho, Antti ;
Turunen, Veli ;
Savolainen, Sakari ;
Airaksinen, Olavi .
SPINE, 2006, 31 (18) :E648-E663
[2]
Preoperative Zung depression scale predicts patient satisfaction independent of the extent of improvement after revision lumbar surgery [J].
Adogwa, Owoicho ;
Parker, Scott L. ;
Shau, David N. ;
Mendenhall, Stephen K. ;
Bydon, Ali ;
Cheng, Joseph S. ;
Asher, Anthony L. ;
McGirt, Matthew J. .
SPINE JOURNAL, 2013, 13 (05) :501-506
[3]
Preoperative Zung Depression Scale predicts outcome after revision lumbar surgery for adjacent segment disease, recurrent stenosis, and pseudarthrosis [J].
Adogwa, Owoicho ;
Parker, Scott L. ;
Shau, David N. ;
Mendenhall, Stephen K. ;
Aaronson, Oran S. ;
Cheng, Joseph S. ;
Devin, Clinton J. ;
McGirt, Matthew J. .
SPINE JOURNAL, 2012, 12 (03) :179-185
[4]
Laminectomy and fusion for the treatment of cervical degenerative myelopathy [J].
Anderson, Paul A. ;
Matz, Paul G. ;
Groff, Michael W. ;
Heary, Robert F. ;
Holly, Langston T. ;
Kaiser, Michael G. ;
Mummaneni, Praveen V. ;
Ryken, Timothy C. ;
Choudhri, Tanvir F. ;
Vresilovic, Edward J. ;
Resnick, Daniel K. .
JOURNAL OF NEUROSURGERY-SPINE, 2009, 11 (02) :150-156
[5]
Using the EuroQol-5D to measure changes in quality of life 12 months after discharge from an intensive care unit [J].
Badia, X ;
Diaz-Prieto, A ;
Gorriz, MT ;
Herdman, M ;
Torrado, H ;
Farrero, E ;
Cavanilles, JM .
INTENSIVE CARE MEDICINE, 2001, 27 (12) :1901-1907
[6]
SURGICAL-TREATMENT FOR CERVICAL SPONDYLITIC MYELOPATHY [J].
EBERSOLD, MJ ;
PARE, MC ;
QUAST, LM .
JOURNAL OF NEUROSURGERY, 1995, 82 (05) :745-751
[7]
Laminectomy for cervical myelopathy [J].
Epstein, NE .
SPINAL CORD, 2003, 41 (06) :317-327
[8]
Does Smoking Influence Fusion Rates in Posterior Cervical Arthrodesis With Lateral Mass Instrumentation? [J].
Eubanks, Jason David ;
Thorpe, Steven W. ;
Cheruvu, Vinay K. ;
Braly, Brett A. ;
Kang, James D. .
CLINICAL ORTHOPAEDICS AND RELATED RESEARCH, 2011, 469 (03) :696-701
[9]
The Pain Disability Questionnaire: Relationship to one-year functional and psychosocial rehabilitation outcomes [J].
Gatchel, RJ ;
Mayer, TG ;
Theodore, BR .
JOURNAL OF OCCUPATIONAL REHABILITATION, 2006, 16 (01) :75-94
[10]
Goldberg Edward J, 2002, Spine J, V2, P408, DOI 10.1016/S1529-9430(02)00441-2