Propensity Score-Matched Analysis of the Association Between Depression, Anxiety, and Patient-Reported Outcomes...

Area of Science:

• Orthopedics
• Neurosurgery
• Psychiatry

Background:

• Preoperative mental health conditions like depression and anxiety are increasingly recognized as potential factors influencing surgical outcomes.
• Lumbar fusion surgery aims to improve function and reduce pain, but patient-reported outcome measures (PROMs) can be affected by various patient-specific factors.

Purpose of the Study:

• To evaluate the association between preoperative depression or anxiety and postoperative PROMs after lumbar fusion.
• To assess the impact of mental health diagnoses on achieving minimal clinically important differences (MCIDs) in patient outcomes.

Main Methods:

• A retrospective study utilizing propensity score matching was conducted.
• Patient data, including mental health diagnoses and PROMs (Oswestry Disability Index, VAS, PROMIS-29), were analyzed.

Main Results:

• Patients with depression or anxiety (33.8%) reported worse baseline and 12-month postoperative outcomes across multiple PROMs.
• Lower achievement of MCID for leg pain was observed in patients with mental health diagnoses.
• Propensity score matching confirmed worse Oswestry Disability Index scores and reduced MCID achievement for leg pain in the mental health group.

Conclusions:

• Preoperative depression and anxiety are linked to poorer postoperative results and reduced functional improvement after lumbar fusion.
• Mental health status may represent a modifiable factor influencing patient recovery and the overall success of lumbar spine surgery.