• Srikanth N Divi, Dhruv K C Goyal, John J Mangan, Matthew S Galetta, Kristen J Nicholson, Taolin Fang, Sourabh Goyal, Thomas J Booth, Daniel Tarazona, Christopher Lucasti, Kaye I David ID, Mark F Kurd, Barrett I Woods, Kris E Radcliff, Jeffery A Rihn, D Greg Anderson, Alan S Hilibrand, Christopher K Kepler, Alexander R Vaccaro, and Gregory D Schroeder.
• Department of Orthopaedic Surgery, Rothman Institute, Thomas Jefferson University, Philadelphia, PA.
• Spine. 2020 Feb 1; 45 (3): 201-207.

Study DesignRetrospective comparative study.ObjectiveThe purpose of this study was to investigate whether preoperative depressive symptoms, measured by mental component score of the Short Form-12 survey (MCS-12), influence patient-reported outcome measurements (PROMs) following an anterior cervical discectomy and fusion (ACDF) surgery for cervical degeneration.Summary Of Background DataThere is a paucity of literature regarding preoperative depression and PROMs following ACDF surgery for cervical degenerative disease.MethodsPatients who underwent an ACDF for degenerative cervical pathology were identified. A score of 45.6 on the MCS-12 was used as the threshold for depression symptoms, and patients were divided into two groups based on this value: depression (MCS-12 ≤45.6) and nondepression (MCS-12 >45.6) groups. Outcomes including Neck Disability Index (NDI), physical component score of the Short Form-12 survey (PCS-12), and Visual Analogue Scale Neck (VAS Neck), and Arm (VAS Arm) pain scores were evaluated using independent sample t test, recovery ratios, percentage of patients reaching the minimum clinically important difference, and multiple linear regression - controlling for factors such as age, sex, and BMI.ResultsThe depression group was found to have significantly worse baseline pain and disability than the nondepression group in NDI (P < 0.001), VAS Neck pain (P < 0.001), and VAS Arm pain (P < 0.001) scores. Postoperatively, both groups improved to a similar amount with surgery based on the recovery ratio analysis. The depression group continued to have worse scores than the nondepression group in NDI (P = 0.010), PCS-12 (P = 0.026), and VAS Arm pain (P = 0.001) scores. Depression was not a significant predictor of change in any PROMs based on regression analysis.ConclusionPatients who presented with preoperative depression reported more pain and disability symptoms preoperatively and postoperatively; however, both groups achieved similar degrees of improvement.Level Of Evidence3.

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