Medical Student University of Illinois College of Medicine Chicago, Illinois, United States
Introduction: Prior studies have associated inferior preoperative mental health with poor outcomes following spine surgery, yet few studies have investigated the correlation of mental health at time of survey collection with these outcomes. This study aims to assess the correlation between mental health at time of patient-reported outcome (PRO) collection following cervical disc replacement (CDR).
Methods: A single-surgeon registry was searched for patients who had undergone CDR, excluding those with indication for infection, cancer, or trauma. PROs were collected preoperatively and up to 1 year postoperatively. Mental health measures evaluated included 12-item Short Form Mental Component Score (SF-12 MCS) and Patient Health Questionnaire-9 (PHQ-9) which were individually assessed via Pearson’s Correlation tests to Patient-reported Outcome Measurement Information System Physical Function (PROMIS PF), SF-12 Physical Component Score (PCS), visual analog scale (VAS) neck and arm pain, and Neck Disability Index (NDI).
Results: 151 patients were included. SF-12 MCS positively correlated with PROMIS PF (range: r=0.369-0.614) and SF-12 PCS (range: r=0.208-0.585) with significance found at two or more time points for each (p≤0.009, all). SF-12 MCS negatively correlated with VAS Neck (range: r=-0.259 to -0.464), VAS Arm (range: r=-0.281 to -0.567), and NDI (range: r=-0.474 to -831) with significance found at three or more time points (p≤0.028, all). PHQ-9 significantly negatively correlated with PROMIS PF (range: r=-0.457 to -0.732) and SF-12 PCS (range: r=-0.332 to -0.629) at all time points (p≤0.013, all). PHQ-9 positively correlated to VAS Neck (range: r=0.351-0.711), VAS Arm (range: r=0.239-0.572), and NDI (range: r=0.602-0.837) at four or more periods (p≤0.032, all).
Conclusion : Patients undergoing CDR who reported lower mental health scores via either SF-12 MCS or PHQ-9 were associated with increased perception of pain and disability. Disability level correlated with mental health at all time periods. Patients with optimized mental health may report higher outcome scores following CDR.
