Patients with a depressive and/or anxiety disorder can achieve optimum Long term outcomes after surgery for grade 1 spondylolisthesis: Analysis from the quality outcomes database (QOD).

Autor: Kashlan O; Department of Neurologic Surgery, University of Michigan, Ann Arbor, Michigan, United States., Swong K; Department of Neurologic Surgery, University of Michigan, Ann Arbor, Michigan, United States., Alvi MA; Department of Neurologic Surgery, Mayo Clinic, Rochester, Minnesota, United States., Bisson EF; Department of Neurological Surgery, University of Utah, Salt Lake City, Utah, United States., Mummaneni PV; Department of Neurological Surgery, University of California, San Francisco, California, United States., Knightly J; Atlantic Neurosurgical Specialists, Morristown, New Jersey, United States., Chan A; Department of Neurological Surgery, University of California, San Francisco, California, United States., Yolcu YU; Department of Neurologic Surgery, Mayo Clinic, Rochester, Minnesota, United States., Glassman S; Norton Leatherman Spine Center, Louisville, Kentucky, United States., Foley K; Department of Neurosurgery, University of Tennessee, Memphis, Tennessee, United States., Slotkin JR; Geisinger Health System, Danville, Pennsylvania, United States., Potts E; Goodman Campbell Brain and Spine, Indianapolis, Indiana, United States., Shaffrey M; Department of Neurological Surgery, University of Virginia, Charlottesville, Virginia, United States., Shaffrey CI; Departments of Neurological Surgery and Orthopedic Surgery, Duke University, Durham, North Carolina, United States., Haid RW Jr; Atlanta Brain and Spine, Atlanta, Georgia., Fu KM; Department of Neurological Surgery, Weill Cornell Medical College, New York City, NY, United States., Wang MY; Department of Neurologic Surgery, University of Miami, Miami, Florida, United States., Asher AL; Neuroscience Institute, Carolinas Healthcare System and Carolina Neurosurgery & Spine Associates, Charlotte, North Carolina, United States., Bydon M; Department of Neurologic Surgery, Mayo Clinic, Rochester, Minnesota, United States. Electronic address: bydon.mohamad@mayo.edu., Park P; Department of Neurologic Surgery, University of Michigan, Ann Arbor, Michigan, United States.
Jazyk: angličtina
Zdroj: Clinical neurology and neurosurgery [Clin Neurol Neurosurg] 2020 Oct; Vol. 197, pp. 106098. Date of Electronic Publication: 2020 Jul 17.
DOI: 10.1016/j.clineuro.2020.106098
Abstrakt: Introduction: In the current study, we sought to compare baseline demographic, clinical, and operative characteristics, as well as baseline and follow-up patient reported outcomes (PROs) of patients with any depressive and/or anxiety disorder undergoing surgery for low-grade spondylolisthesis using a national spine registry.
Patients and Methods: The Quality Outcomes Database (QOD) was queried for patients undergoing surgery for Meyerding grade 1 lumbar spondylolisthesis undergoing 1-2 level decompression or 1 level fusion at 12 sites with the highest number of patients enrolled in QOD with 2-year follow-up data.
Results: Of the 608 patients identified, 25.6 % (n = 156) had any depressive and/or anxiety disorder. Patients with a depressive/anxiety disorder were less likely to be discharged home (p < 0.001). At 3=months, patients with a depressive/anxiety disorder had higher back pain (p < 0.001), lower quality of life (p < 0.001) and higher disability (p = 0.013); at 2 year patients with depression and/or anxiety had lower quality of life compared to those without (p < 0.001). On multivariable regression, depression was associated with significantly lower odds of achieving 20 % or less ODI (OR 0.44, 95 % CI 0.21-0.94,p = 0.03). Presence of an anxiety disorder was not associated with decreased odds of achieving that milestone at 3 months. The presence of depressive-disorder, anxiety-disorder or both did not have an impact on ODI at 2 years. Finally, patient satisfaction at 2-years did not differ between the two groups (79.8 % vs 82.7 %,p = 0.503).
Conclusion: We found that presence of a depressive-disorder may impact short-term outcomes among patients undergoing surgery for low grade spondylolisthesis but longer term outcomes are not affected by either a depressive or anxiety disorder.
(Copyright © 2020 Elsevier B.V. All rights reserved.)
Databáze: MEDLINE
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