Relating preoperative MCS-12 to microdiscectomy outcomes

Author:

Heard Jeremy C.,Lee YunsooORCID,Ezeonu Teeto,Lambrechts Mark J.,Narayanan Rajkishen,Yeung Caleb,Wright Justin,Paulik John,Purtill Caroline,Mangan John J.,Kurd Mark F.,Kaye Ian D.,Canseco Jose A.,Hilibrand Alan S.,Vaccaro Alexander R.,Schroeder Gregory D.,Kepler Christopher K.

Abstract

Abstract Purpose To determine the impact of poor mental health on patient-reported and surgical outcomes after microdiscectomy. Methods Patients ≥ 18 years who underwent a single-level lumbar microdiscectomy from 2014 to 2021 at a single academic institution were retrospectively identified. Patient-reported outcomes (PROMs) were collected at preoperative, three-month, and one-year postoperative time points. PROMs included the Oswestry Disability Index (ODI), Visual Analog Scale Back and Leg (VAS Back and VAS Leg, respectively), and the mental and physical component of the short form-12 survey (MCS and PCS). The minimum clinically important differences (MCID) were employed to compare scores for each PROM. Patients were categorized as having worse mental health or better mental health based on a MCS threshold of 50. Results Of 210 patients identified, 128 (61%) patients had a preoperative MCS score ≤ 50. There was no difference in 90-day surgical readmissions or spine reoperations within one year. At 3- and 12-month time points, both groups demonstrated improvements in all PROMs (p < 0.05). At three months postoperatively, patients with worse mental health had significantly lower PCS (42.1 vs. 46.4, p = 0.004) and higher ODI (20.5 vs. 13.3, p = 0.006) scores. Lower mental health scores were associated with lower 12-month PCS scores (43.3 vs. 48.8, p < 0.001), but greater improvements in 12-month ODI (− 28.36 vs.  − 18.55, p = 0.040). Conclusion While worse preoperative mental health was associated with lower baseline and postoperative PROMs, patients in both groups experienced similar improvements in PROMs. Rates of surgical readmissions and reoperations were similar among patients with varying preoperative mental health status.

Publisher

Springer Science and Business Media LLC

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