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Published on: July 5, 2011
Relating preoperative MCS-12 to microdiscectomy outcomes
Jeremy C Heard1, Yunsoo Lee2, Teeto Ezeonu1
1Spine Surgery, Department of Orthopaedic Surgery, Rothman Institute, Thomas Jefferson University, 925 Chestnut Street, 5thFloor, Philadelphia, PA, 19107, USA.
Purpose:
To determine the impact of poor mental health on patient-reported and surgical outcomes after microdiscectomy.
Methods:
Patients ≥ 18 years who underwent a single-level lumbar microdiscectomy from 2014 to 2021 at a single academic institution were retrospectively identified. Patient-reported outcomes (PROMs) were collected at preoperative, three-month, and one-year postoperative time points. PROMs included the Oswestry Disability Index (ODI), Visual Analog Scale Back and Leg (VAS Back and VAS Leg, respectively), and the mental and physical component of the short form-12 survey (MCS and PCS). The minimum clinically important differences (MCID) were employed to compare scores for each PROM. Patients were categorized as having worse mental health or better mental health based on a MCS threshold of 50.
Results:
Of 210 patients identified, 128 (61%) patients had a preoperative MCS score ≤ 50. There was no difference in 90-day surgical readmissions or spine reoperations within one year. At 3- and 12-month time points, both groups demonstrated improvements in all PROMs (p < 0.05). At three months postoperatively, patients with worse mental health had significantly lower PCS (42.1 vs. 46.4, p = 0.004) and higher ODI (20.5 vs. 13.3, p = 0.006) scores. Lower mental health scores were associated with lower 12-month PCS scores (43.3 vs. 48.8, p < 0.001), but greater improvements in 12-month ODI (- 28.36 vs. - 18.55, p = 0.040).
Conclusion:
While worse preoperative mental health was associated with lower baseline and postoperative PROMs, patients in both groups experienced similar improvements in PROMs. Rates of surgical readmissions and reoperations were similar among patients with varying preoperative mental health status.
Insights
Poor mental health impacts patient-reported outcomes after microdiscectomy but does not affect surgical outcomes. Patients with worse mental health showed similar improvements in pain and function over time.
Area of Science:
- Neurosurgery
- Orthopedics
- Psychology
Background:
- Mental health significantly influences patient recovery and outcomes across various surgical procedures.
- Understanding the specific impact of mental health on spinal surgery outcomes is crucial for comprehensive patient care.
Purpose of the Study:
- To investigate the association between preoperative mental health status and patient-reported outcomes (PROMs) and surgical outcomes following lumbar microdiscectomy.
- To compare outcomes between patients with worse versus better mental health.
Main Methods:
- Retrospective analysis of 210 adult patients undergoing lumbar microdiscectomy.
- Collection of PROMs including Oswestry Disability Index (ODI) and Short Form-12 (MCS and PCS) at multiple time points.
- Categorization of patients based on preoperative mental health scores (MCS threshold of 50).
Main Results:
- 61% of patients had worse preoperative mental health (MCS ≤ 50).
- No significant differences in 90-day readmissions or 1-year reoperations between groups.
- Patients with worse mental health reported significantly poorer physical function (PCS) and higher disability (ODI) at 3 and 12 months post-surgery.
- Both groups showed significant improvements in all PROMs over time.
Conclusions:
- Worse preoperative mental health is linked to lower baseline and postoperative patient-reported outcomes after microdiscectomy.
- Despite initial differences, patients with varying mental health statuses achieve comparable functional improvements and surgical success rates.
- Mental health status does not appear to influence short-term surgical complication rates like readmissions or reoperations.
