The associations between psychosocial factors and anterior cervical discectomy and fusion outcomes
University of New Brunswick
We completed a longitudinal analysis to identify preoperative psychological prognostic factors and further investigate their effects on post-operative trajectories of disability and arm and neck pain in patients undergoing anterior cervical discectomy and fusion (ACDF) surgery for cervical radiculopathy. Numeric pain rating scales (NPRS) and the Neck Disability Index (NDI) were used to quantify pain and disability at 3-, 12-, and 24- months post-surgery. Depression, depression risk, and mental well-being were assessed prior to surgery. We included data from 352 patients (mean[SD] age = 50.85 [9.52]; female sex[%] = 43.75%) in Poisson regression models. Depression was predictive of poor disability outcomes (IRR [95% CI] = 3.03 [1.76 to 5.21]); moderate-to-severe depression risk was predictive of all poor outcomes (arm pain: (IRR [95% CI] = 1.80 [1.18 to 2.74]); neck pain: (IRR [95% CI] = 2.29 [1.43 to 3.66]); disability: (IRR [95% CI] = 12.84 [4.07 to 40.44])); and, MCS was protective against poor outcomes (arm pain: (IRR [95% CI] = 0.73 [0.59 to 0.89]); neck pain: (IRR [95% CI] = 0.67 [0.53 to 0.84]); disability: (IRR [95% CI] = 0.47 [0.36 to 0.62])). After adjustments, effects of the predictors on the outcomes were all significant in terms of poor disability (depression: (IRR [95% CI] = 2.82 [1.62 to 4.89]); moderate-to-severe depression risk: (IRR [95% CI] = 9.72 [3.12 to 30.35); MCS: (IRR [95% CI] = 0.53 [0.39 to 0.72])). Overall, psychological factors have some influence on recovery patterns after ACDF and may need to be acknowledged in patient health history prior to surgery.