Pretreatment of Depression before Cervical Spine Surgery Improves Patients' Perception of Postoperative Health Status

A Retrospective, Single Institutional Experience

Aladine A. Elsamadicy, Owoicho Adogwa, Joseph Cheng, Carlos Bagley

Research output: Contribution to journalArticle

14 Citations (Scopus)

Abstract

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 pretreatment of depression before surgery improved patient-reported outcomes measures and overall satisfaction with care. Methods A total of 140 adult patients (pretreated 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 before 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 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. At baseline there were no significant differences in NDI (P = 0.11), SF-12 physical component score (PCS; P = 0.63), and neck pain VAS (P = 0.80). 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. At 1 year postoperatively, both cohorts demonstrated similar improvement in neck pain VAS (P = 0.92), NDI (P = 0.32), SF-12 PCS (P = 0.15), and SF-12 mental component score (P = 0.38). These results were durable through 2 years. At 2 years, both the demonstrated similar improvement from baseline in neck pain VAS (P = 0.88), NDI (P = 0.43), SF-12 PCS (P = 0.28), and SF-12 mental component score (P = 0.40). Conclusion Our study suggests that in patients with depression, pretreatment with antidepressants before surgery significantly improves their perception and pain and functional disability.

Original languageEnglish (US)
Pages (from-to)214-219
Number of pages6
JournalWorld Neurosurgery
Volume87
DOIs
StatePublished - Mar 1 2016

Fingerprint

Health Status
Spine
Depression
Visual Analog Scale
Neck Pain
Neck
Antidepressive Agents
Diskectomy
Pain Perception
Postoperative Pain
Mood Disorders
Psychiatry
Demography
Incidence
Wounds and Injuries
Research

Keywords

  • Affective disorder
  • Cervical spine
  • Depression
  • Key words ACDF
  • Pretreatment
  • Surgical outcomes

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

Cite this

Pretreatment of Depression before Cervical Spine Surgery Improves Patients' Perception of Postoperative Health Status : A Retrospective, Single Institutional Experience. / Elsamadicy, Aladine A.; Adogwa, Owoicho; Cheng, Joseph; Bagley, Carlos.

In: World Neurosurgery, Vol. 87, 01.03.2016, p. 214-219.

Research output: Contribution to journalArticle

@article{63f52f339e8f46b5895101731ce8b2cb,
title = "Pretreatment of Depression before Cervical Spine Surgery Improves Patients' Perception of Postoperative Health Status: A Retrospective, Single Institutional Experience",
abstract = "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 pretreatment of depression before surgery improved patient-reported outcomes measures and overall satisfaction with care. Methods A total of 140 adult patients (pretreated 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 before 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 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. At baseline there were no significant differences in NDI (P = 0.11), SF-12 physical component score (PCS; P = 0.63), and neck pain VAS (P = 0.80). 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. At 1 year postoperatively, both cohorts demonstrated similar improvement in neck pain VAS (P = 0.92), NDI (P = 0.32), SF-12 PCS (P = 0.15), and SF-12 mental component score (P = 0.38). These results were durable through 2 years. At 2 years, both the demonstrated similar improvement from baseline in neck pain VAS (P = 0.88), NDI (P = 0.43), SF-12 PCS (P = 0.28), and SF-12 mental component score (P = 0.40). Conclusion Our study suggests that in patients with depression, pretreatment with antidepressants before surgery significantly improves their perception and pain and functional disability.",
keywords = "Affective disorder, Cervical spine, Depression, Key words ACDF, Pretreatment, Surgical outcomes",
author = "Elsamadicy, {Aladine A.} and Owoicho Adogwa and Joseph Cheng and Carlos Bagley",
year = "2016",
month = "3",
day = "1",
doi = "10.1016/j.wneu.2015.11.067",
language = "English (US)",
volume = "87",
pages = "214--219",
journal = "World Neurosurgery",
issn = "1878-8750",
publisher = "Elsevier Inc.",

}

TY - JOUR

T1 - Pretreatment of Depression before Cervical Spine Surgery Improves Patients' Perception of Postoperative Health Status

T2 - A Retrospective, Single Institutional Experience

AU - Elsamadicy, Aladine A.

AU - Adogwa, Owoicho

AU - Cheng, Joseph

AU - Bagley, Carlos

PY - 2016/3/1

Y1 - 2016/3/1

N2 - 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 pretreatment of depression before surgery improved patient-reported outcomes measures and overall satisfaction with care. Methods A total of 140 adult patients (pretreated 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 before 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 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. At baseline there were no significant differences in NDI (P = 0.11), SF-12 physical component score (PCS; P = 0.63), and neck pain VAS (P = 0.80). 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. At 1 year postoperatively, both cohorts demonstrated similar improvement in neck pain VAS (P = 0.92), NDI (P = 0.32), SF-12 PCS (P = 0.15), and SF-12 mental component score (P = 0.38). These results were durable through 2 years. At 2 years, both the demonstrated similar improvement from baseline in neck pain VAS (P = 0.88), NDI (P = 0.43), SF-12 PCS (P = 0.28), and SF-12 mental component score (P = 0.40). Conclusion Our study suggests that in patients with depression, pretreatment with antidepressants before surgery significantly improves their perception and pain and functional disability.

AB - 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 pretreatment of depression before surgery improved patient-reported outcomes measures and overall satisfaction with care. Methods A total of 140 adult patients (pretreated 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 before 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 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. At baseline there were no significant differences in NDI (P = 0.11), SF-12 physical component score (PCS; P = 0.63), and neck pain VAS (P = 0.80). 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. At 1 year postoperatively, both cohorts demonstrated similar improvement in neck pain VAS (P = 0.92), NDI (P = 0.32), SF-12 PCS (P = 0.15), and SF-12 mental component score (P = 0.38). These results were durable through 2 years. At 2 years, both the demonstrated similar improvement from baseline in neck pain VAS (P = 0.88), NDI (P = 0.43), SF-12 PCS (P = 0.28), and SF-12 mental component score (P = 0.40). Conclusion Our study suggests that in patients with depression, pretreatment with antidepressants before surgery significantly improves their perception and pain and functional disability.

KW - Affective disorder

KW - Cervical spine

KW - Depression

KW - Key words ACDF

KW - Pretreatment

KW - Surgical outcomes

UR - http://www.scopus.com/inward/record.url?scp=84960086555&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84960086555&partnerID=8YFLogxK

U2 - 10.1016/j.wneu.2015.11.067

DO - 10.1016/j.wneu.2015.11.067

M3 - Article

VL - 87

SP - 214

EP - 219

JO - World Neurosurgery

JF - World Neurosurgery

SN - 1878-8750

ER -