Researchers recently published an article in the Journal of Neurosurgery: Spine to assess the predictive value of preoperative depression on two-year postoperative outcomes.
There were a total of 69 patients included in the study. The patients underwent revision neural decompression and instrumented fusion for adjacent segment disease, pseudarthrosis or same-level recurrent stenosis. The researchers found:
1. Two years after surgery, the VAS-BP was significantly improved compared to preoperative status. The breakdown for improvement in each identified revision surgery includes:
• Adjacent segment disease: 9±2 vs. 4.01±2.56
• Pseudarthrosis: 7.41±1 vs. 5±3.08
• Same-level recurrent stenosis: 7±2 vs. 5±2.34
2. Two-year ODI was also significantly improved for all three procedures:
• Adjacent segment disease: 29±9 vs. 23.1±10.18
• Pseudarthrosis: 28.47±5.85 vs. 24.41±7.75
• Same-level recurrent stenosis: 30.83±5.38 vs. 26.29±4.1
3. There were other independent factors making an impact on pain and functional outcomes as well. Those factors include age, body mass index, symptom duration, smoking, comorbidities, severity of preoperative pain and disability.
4. An increased preoperative Zung Self-Rating Depression Scale score was significantly associated with lower two-year improvement in disability after revision surgery in elderly patients with symptomatic adjacent segment disease, pseudarthrosis or recurrent stenosis. "The extent of preoperative depression is an independent predictor of less functional improvement following revision lumbar surgery in elderly patients with symptomatic ASD, psuedarthrosis or recurrent stenosis," the authors concluded.
5. The study authors recommended a timely diagnosis and treating depression and somatic anxiety among patients undergoing revision surgery to potentially improve postoperative functional status.