Effect of Baseline Veterans RAND-12 Mental Composite Score on Postoperative Patient-Reported Outcome Measures for...

Area of Science:

• Spine surgery outcomes
• Patient-reported outcome measures
• Mental health in surgical patients

Background:

• Limited research exists on the impact of preoperative mental health on cervical disk replacement (CDR) outcomes.
• The Veterans RAND-12 (VR-12) Mental Composite Score (MCS) is a key indicator of mental health status.

Purpose of the Study:

• To investigate how baseline VR-12 Mental Composite Score (MCS) affects clinical outcomes after CDR for herniated disk.
• To compare outcomes between patients with worse versus better preoperative mental health.

Main Methods:

• Retrospective review of 109 patients undergoing CDR for herniated disk.
• Patients were stratified into two groups based on VR-12 MCS: <50 (worse mental health) and ≥50 (better mental health).
• Collected patient-reported outcome measures including VR-12, SF-12, PHQ-9, VAS pain, and Neck Disability Index preoperatively and up to 2 years postoperatively.

Main Results:

• The worse mental health cohort (n=50) reported inferior outcomes across all domains preoperatively and postoperatively.
• This cohort showed greater 6-week and final postoperative improvement in VR-12 MCS and SF-12 MCS.
• Higher rates of minimum clinically important difference achievement were observed in the worse mental health group for mental health and PHQ-9 outcomes.

Conclusions:

• Worse baseline mental health in CDR patients is associated with poorer overall clinical outcomes.
• Despite initial deficits, patients with worse baseline mental health experience more significant improvements in mental health domains.
• Mental health status is a critical factor influencing patient recovery and perceived outcomes following cervical disk replacement.