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Preoperative psychological health impacts pain and disability outcomes following anterior cervical discectomy and fusion for cervical radiculopathy
Journal article   Open access   Peer reviewed

Preoperative psychological health impacts pain and disability outcomes following anterior cervical discectomy and fusion for cervical radiculopathy

Erin E Cunningham, Erin Bigney, Stephan U Dombrowski, Niels Wedderkopp, Neil Manson, Najmeddan Attabib, Edward Abraham, Chris Small, Eden Richardson, Michael M H Yang, …
Scientific reports, Vol.15(1), 14861
2025
DOI: https://doi.org/10.1038/s41598-025-97575-2
PMID: 40295568
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Published2.21 MBDownloadView
CC BY-NC-ND V4.0,  Open Access

Abstract

Adult Aged Cervical Vertebrae - surgery Depression Disability Evaluation Diskectomy - adverse effects Diskectomy - methods Female Humans Male Mental Health Middle Aged Neck Pain - psychology Neck Pain - surgery Preoperative Period Radiculopathy - psychology Radiculopathy - surgery Retrospective Studies Spinal Fusion - adverse effects Spinal Fusion - methods Spinal Fusion - psychology Treatment Outcome
This study aimed to estimate the effects of preoperative psychological health on postoperative outcomes in patients undergoing surgery for cervical spondylotic radiculopathy. This retrospective cohort study included data from patients enrolled in the Canadian Spine Outcomes and Research Network who underwent anterior cervical discectomy and fusion for radiculopathy. Preoperative psychological health was measured with the Patient Health Questionnaire-8 (PHQ-8), and depression and severe psychological symptomology were measured with the Mental Component Score of the Short Form Survey-12 (MCS). Surgical outcomes comprised trajectory subgroups for neck pain and arm pain (numeric rating scales) and disability (neck disability index) measured preoperatively and 3, 12, and 24 months after surgery. For each outcome, patients were dichotomized as following either a poor or a fair-to-excellent trajectory. Average treatment effects were estimated with doubly robust propensity score models using inverse probability of treatment weights accounting for multiple confounders. We included data from 352 patients (43.8% female). Approximately half (52.1%) of patients were identified as depressed based on the PHQ-8, while 61.8% and 33.1% were classified as experiencing depression or severe psychological symptomology, respectively, on the MCS. In fully adjusted models, patients with PHQ-8-measured depression were at increased risk of poor postoperative outcomes for disability (risk ratio[95% CI] = 6.73[1.85 to 24.45]) and neck pain (RR[95% CI] = 1.90[1.09 to 3.32]). Patients with MCS-measured depression were at elevated risk of a poor disability outcome (RR[95% CI] = 2.77[1.30 to 5.90]). Patients reporting severe psychological symptomatology had an increased likelihood of poor disability, neck pain, and arm pain outcomes (RR[95% CI] = 1.82 [1.17 to 2.82] to 2.84[1.58 to 5.09]). These findings highlight the high prevalence of negative psychological features and their impacts on neck surgery outcomes. Future research should prioritize the development and evaluation of preoperative interventions to optimize psychological well-being and improve surgical outcomes in this population.

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Collaboration types
Domestic collaboration
International collaboration
Citation topics
1 Clinical & Life Sciences
1.129 Back pain
1.129.795 Cervical Spine Surgery
Web Of Science research areas
Clinical Neurology
ESI research areas
Clinical Medicine
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