Patient-reported outcomes after lumbar decompression (LD) surgery are analyzed to see how often they meet the criteria for a “minimal clinically relevant difference” (MCID). Little is known about how preoperative depression affects the success of LD patients in reaching MCIDs for mental health, physical function, and pain. 

Primary LD operations were looked at in retrospect by reviewing a surgical registry. The preoperative Patient Health Questionnaire 9 score was used to categorize patients into groups based on the severity of their depression symptoms. Subgroups of the Patient Health Questionnaire 9 were investigated for their correlations with demographic and surgical characteristics, and variations between groups were evaluated. 

At each time point, researchers compared the proportions of each group who met predetermined MCID standards regarding physical function, pain, disability, and mental health. The majority of the study’s participants (60.9%) were men, and the severity of their preoperative depression ranged from mild (170) to moderate (86) to severe (65) among the 321 participants. At 6 weeks and 3 months post-operatively, patients in the moderate and severe groups had a significantly higher rate of MCID attainment for disability. At the 1-year mark, those in the severe group achieved MCID for mental health at a much higher rate. The rate at which patients achieved MCID for pain and physical function throughout the first year after LD was similar regardless of the severity of their preoperative depression symptoms.

Among those who experienced severe depressive symptoms, the MCID success rates for disability at 6 weeks and mental health at 1 year were greater. In addition, this research shows that patients with varying degrees of depression before LD all have the same chance of reaching MCID 12 months after the procedure.

Source: journals.lww.com/jspinaldisorders/Abstract/2022/11000/Influence_of_Preoperative_Depressive_Burden_on.10.aspx