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Spine (Phila Pa 1976). 2015 Mar 1;40(5):E266-71. doi: 10.1097/BRS.0000000000000743.

The impact of the depression and anxiety on prognosis of cervical total disc replacement.

Author information

1
From the Department of Orthopedics, Shanghai Changzheng Hospital, Shanghai, China.

Abstract

STUDY DESIGN:

Prospective clinical study.

OBJECTIVE:

To identify changes in depression and anxiety after cervical total disc replacement (CTDR) among patients with cervical spondylosis, and to investigate their effects on the prognosis.

SUMMARY OF BACKGROUND DATA:

Previous researches have reported relationships between mood disorders and lumbar surgery. There have been no previous studies on the effects of depressive and anxiety on the CTDR outcome at the 2-year postoperative phase.

METHODS:

Eighty-five patients with cervical spondylosis who underwent CTDR were included. Patients were evaluated preoperatively and at 6 postoperative time points, including 1 week, 1 month, 3 months, 6 months, 1 year, and 2 years. Depression and anxiety were evaluated by using the Zung Self-Rating Depression Scale and the Zung Self-Rating Anxiety Scale. Neurological function was evaluated by using the visual analogue scale and the Japanese Orthopaedic Association. The quality of life was assessed by a 36-item Short-Form Health Survey. A Spearman rank correlation analysis was used.

RESULTS:

All patients had improvements in clinical symptoms and neurological function. Twelve (14.12%) patients had symptoms of depression and 21 (24.71%) patients had symptoms of anxiety. There was a significant difference between the preoperative and the postoperative Zung Self-Rating Anxiety Scale scores, whereas the Zung Self-Rating Depression Scale scores were not significantly different over time. For all patients, the visual analogue scale scores and the 36-item Short-Form Health Survey scores were associated with the postoperative level of depression and anxiety but not age or the Japanese Orthopaedic Association score.

CONCLUSION:

Some patients with cervical spondylosis have preoperative depression and/or anxiety. CTDR may provide some improvements in these psychological symptoms. The presence of depression and/or anxiety may have a negative influence on the patient's prognosis.

LEVEL OF EVIDENCE:

3.

PMID:
25494313
DOI:
10.1097/BRS.0000000000000743
[Indexed for MEDLINE]

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