Thursday, September 27, 2018 1:05 PM–2:05 PM Understanding Anxiety and Depression when Performing Spine Surgery: 118. Depression symptoms are associated with poor functional status among operative spinal deformity patients

Abstract

BACKGROUND CONTEXT Individuals with adult spinal deformity (ASD) often experience pain and functional limitations, which are the primary concerns for ASD patients to seek surgical care. However, the influence of depression on clinical outcomes following spine surgery is less known. PURPOSE To evaluate the association of mental health status, measured by SF-36 mental component score (MCS) preoperatively, and functional status at 2-year postoperatively. STUDY DESIGN/SETTING This is a multicenter retrospective review of prospectively collected cases. PATIENT SAMPLE The study included operative ASD patients. OUTCOME MEASURES The functional status was assessed using the Oswestry Disability Index (ODI). METHODS A total of 666 operative ASD patients were identified in a prospective database and stratified in two groups based on their preoperative MCS: the low-MCS group included patients with a MSC below the 25 percentile of the cohort; the high-MCD included patients in the upper upper 25 percentile. Demographics, surgical characteristics, radiographic parameters and patient reported outcome measures (PROMs) were obtained at each follow-up. Patients’ profiles were compared between these two groups using Student t-test, Wilcoxon Rank-Sum test and Chi-square test where appropriate. All the analysis were performed in SPSS. RESULTS In total, 498 patients (58.3 yo, 79% female, mean MCS=45.6±13.8). Values for low and high MCS were 35.0 and 57.3. The stratification by MCS percentiles led to a mean MCS of 28.2 versus 62.0 (p CONCLUSIONS Our data has demonstrated that ASD patients with a low-MCS are below the threshold of clinically depressed patients (MCS=34.84); they are more likely to experience functional limitations following spinal deformity surgery and less likely to be satisfied, even if the same treatment goal is achieved from a clinical perspective. Incorporating the psychological factors may assist in decision making, and setting of expectations for complex surgery related to ASD. FDA DEVICE/DRUG STATUS This abstract does not discuss or include any applicable devices or drugs.