Relationship between depression and clinical outcome following anterior cervical discectomy and fusion

Kevin Phan, Dane Moran, Thomas Kostowski, Risheng Xu, Rory Goodwin, Benjamin Elder, Seba Ramhmdani, Ali Bydon


Background: Anterior cervical discectomy and fusion (ACDF) is a commonly performed procedure for patients with symptomatic degenerative conditions of the cervical spine. The objective is to assess the impact of preoperative depression and other baseline characteristics on patient reported clinical outcomes following ACDF surgery based on the experience at our institution.
Methods: This was a retrospective cohort study of some patients undergoing ACDF at a single institution from 2012 to 2014. Ninety-three patients that underwent an ACDF procedure were included. The primary outcome measure was post-operative Nurick score.
Results: Sixteen (17.2%) patients had a formal diagnosis of depression compared to 77 (82.8%) patients without depression. On univariate analysis, patients with depression had statistically significantly higher Nurick scores compared to patients without depression after surgery (coefficient =0.55, 95% CI: 0.21–0.90, P=0.002). On multivariate analysis, there was a trend toward higher postoperative Nurick scores in patients that had depression (coefficient =0.31, 95% CI: −0.01–0.63, P=0.057).
Conclusions: This small retrospective study reveals an inverse relationship between preoperative depression and functional outcome. Further research should be performed to investigate this relationship and to investigate if treating depression can improve postoperative outcomes.