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Predicting Acute Changes in Depressive Symptoms Following Lumbar Decompression.
Conor P Lynch1, Elliot D K Cha1, Madhav R Patel1
1Department of Orthopedic Surgery, Rush University Medical Center, Chicago, USA.
International Journal of Spine Surgery
|July 31, 2022
Summary
Minimally invasive lumbar decompression (MIS LD) improves depression for most patients. Preoperative depression severity, insurance, and smoking predict short-term outcomes after MIS LD.
Area of Science:
- Spine Surgery
- Psychiatric Comorbidities
- Minimally Invasive Procedures
Background:
- Depressive symptoms often improve after minimally invasive lumbar decompression (MIS LD).
- However, some patients experience worsening depression post-surgery.
- Predictors of these changes require investigation.
Purpose of the Study:
- To identify predictors of short-term changes in depressive symptoms following MIS LD.
- To analyze the impact of preoperative factors on postoperative mood.
Main Methods:
- Retrospective analysis of a prospective surgical database (2016-2020).
- Inclusion of 216 patients undergoing primary MIS LD.
- Preoperative and postoperative (6 weeks to 1 year) 9-Item Patient Health Questionnaire (PHQ-9) scores were collected.
- Multivariable regression analyzed predictors of PHQ-9 change.
Main Results:
- Patients showed significant depressive symptom improvement at all postoperative timepoints (P < 0.001).
- Moderate to severe preoperative depression predicted worse outcomes at all timepoints.
- Mild preoperative depression predicted worse outcomes at 6 and 12 weeks.
- Private insurance and non-smoking status predicted better outcomes at 12 weeks.
Conclusions:
- Depression generally improves after MIS LD.
- Preoperative depression severity, insurance type, and smoking status are significant predictors of short-term postoperative mood changes.
