72 - What is the Effect of Preoperative Depression on Outcomes after Minimally Invasive Surgery for Adult Spinal Deformity? A Prospective Cohort Analysis using a Multicenter Registry.

Saturday, June 3, 2023

11:32 AM – 11:34 AM

Location: Salons 10-12

Presenting Author (Person doing the Podium Present(s)

NA

Nitin Agarwal, M.D.

University of Pittsburgh Medical Center, United States

Co-Author(s)

VL

Vijay Letchuman, M.D.

University of California, San Francisco, United States
RL

Raj S. Lavadi, M.B.B.S.

Washington University School of Medicine in St. Louis, United States
VL

Vivian P. Le, M.P.H.

Columbia University Irving Medical Center, United States
AA

Alexander Aabedi, M.D.

University of California, San Francisco, United States
SS

Saman Shabani, M.D.

Medical College of Wisconsin, United States
AC

Andrew K. Chan, M.D.

Columbia University Irving Medical Center, United States
PP

Paul Park, M.D.

Semmes Murphey Clinic, United States
JU

Juan S. Uribe, M.D.

Chief of Spinal Disorders
Barrow Neurological Institute
phoenix, Arizona, United States
JT

Jay D. Turner, M.D., Ph.D.

Neurosurgeon
Barrow Neurological Institute
Phoenix, Arizona, United States
Robert K. Eastlack, M.D.

Partner, Spine Section, Division of Orthopaedic Surgery
Scripps Clinic
La Jolla, California, United States
RF

Richard G. Fessler, M.D., Ph.D.

Professor
Rush University Medical Center
Chicago, Illinois, United States
KF

Kai-Ming Fu, M.D., Ph.D.

Weil Cornell Medical Center, United States
MW

Michael Y. Wang, MD

Professor
University of Miami Department of Neurosurgery
Miami, Florida, United States
AK

Adam S. Kanter, M.D.

Hoag Pickup Family Neurosciences Institute, United States
DO

David O. Okonkwo, M.D., Ph.D.

University of Pittsburgh Medical Center, United States
Pierce D. Nunley, MD

Director
Spine Insitute of Louisiana
Shreveport, Louisiana, United States
Neel Anand, MD

Professor of Orthopaedic Surgery
Cedars-Sinai Medical Center
LOS ANGELES, California, United States
Gregory M. Mundis, Jr., M.D.

Director San Diego Spine Fellowship
Scripps Clinic
Encinitas, California, United States
PP

Peter G. Passias, M.D.

Spine Surgeon
NYU Langone Orthopedic Hospital
New York, New York, United States
SB

Shay Bess, M.D.

Spine surgeon
Denver International Spine Center
castle rock, Colorado, United States
CS

Christopher I. Shaffrey, Sr., MD

Duke University Medical Center
Durham, North Carolina, United States
DC

Dean Chou, M.D.

Columbia University Irving Medical Center, United States
PM

Praveen V. Mummaneni, MD, MBA

Professor
University of California San Francisco
san francisco, California, United States

Disclosure(s):

Robert K. Eastlack, M.D.: No relevant disclosure to display

Introduction: Depression has been implicated with worse immediate preoperative outcomes, yet the specific impact on outcomes requires further clarity. This study aims to evaluate the role of depression in patients with adult spinal deformity (ASD) in the perioperative setting.

Aims/

Objectives: To evaluate the role of depression in patients with ASD in the perioperative setting.

Methods: Patients undergoing minimally invasive surgery (MIS) for ASD with a minimum of two years of postoperative follow-up were included from a prospectively collected, multicenter registry. Two cohorts of patients were identified consisting of those either affirming or denying depression on preoperative assessment. The patient-reported outcomes (PROs) compared included ODI, NRS back and leg pain, SRS-22r, SF-36 PCS, SF-36 MCS, EQ-5D, and EQ-5D VAS. Univariate comparisons were conducted with t-tests as well as nonparametric tests. Categorical variables were compared using Fisher’s exact test.

Results: A total of 15 out of the 85 (17.6%) patient study cohort screened positive for preoperative depression. At 2-year follow-up only 7 patients still reported depression, representing a 53.3% decrease. Both cohorts did demonstrate improvement in their patient-reported outcome measures; however, at 2-year follow-up those without depression had statistically better outcomes based on the EQ-5D (p < 0.05), EQ-5D VAS (p < 0.01), and MCS (p < 0.01). No significant differences were observed between the two cohorts with regards to the Charlson comorbidity index, spinopelvic parameters, treatment data, or complications.

Conclusions: Despite the relatively high frequency of ASD patients reporting preoperative depression, improvements were observed in their PROs at 2-year follow-up after undergoing MIS. However, those without depression had statistically significant better PROs. Nevertheless, the number of patients screening positive for depression on follow-up after surgery decreased by over 50%. Mental health screening and services remain an integral part of perioperative patient care.