Assessing the Correlation between Lumbar Spine Surgery and Mental Health Disorders

Jakoi A1*, D’Oro A2, Buser Z2, Friedl M3 and Wang JC2

1Orthopedic Health of Kansas City, Kansas City, Missouri, USA
2Department of Orthopedic Surgery, Keck School of Medicine, University of Southern California, USA
3Department of Orthopedic Surgery, University of Florida, Jacksonville, Florida, USA

^*Correspondance to: Andre Jakoi 

 PDF  Full Text DOI: 10.25107/2474-1647.2811

Abstract

Object: We sought to analyze the overall prevalence of mental health disorders among patients who undergo initial and revision lumbar spine surgery, and to demonstrate if mental health disorders increase patients’ likelihood of undergoing revision surgery. We also sought to establish trends in anti-depressant prescription medications among patients with mental health disorders and to evaluate their effect on rates of revision surgery. Methods: Retrospective review of patients who underwent lumbar spine surgery from 2007-2014 within the Humana Insurance subset of the PearlDiver Inc. database. Rates of revision surgery were compared between longitudinally-followed lumbar spine surgery patients with and without diagnoses of mental health disorders. Chi-squared, odds-ratio, and Wilcoxon rank-sum tests were used for statistical analysis. Results: 117,507 patients underwent lumbar spine surgery between 2007 and 2014. Of those patients, 29,325 (25.0%) were diagnosed with a mental health disorder within 90 days prior to surgery. There were 67,079 (57.1%) patients diagnosed with a mental health disorder at some point from 2007-2015 and 50,428 (42.9%) patients never diagnosed from 2007-2015. Women were more likely to be diagnosed with mental health disorders (p<0.0001, OR: 2.68, CI: 2.60-2.76) and more likely to be prescribed anti-depressants (p<0.0001, OR: 1.47, CI: 1.40-1.55). Patients diagnosed with a mental health disorder within 90 days of their first surgery had revision surgeries at a rate of 9.6%, significantly higher than the rate of 7.2% for patients who were never diagnosed with a mental health disorder (p<0.0001, OR: 1.37, CI: 1.30-1.44). Patients who were prescribed anti-depressants had higher rates of revision surgery than patients not prescribed anti-depressants (p<0.0001, OR: 1.19, CI: 1.10-1.29). Conclusion: There is a high prevalence of mental health disorders among patients who undergo lumbar spine surgery, and an increased risk of revision surgery among patients with mental health disorders. Patients prescribed anti-depressants underwent higher rates of revision surgery

Keywords

Lumbar; Mental Health; Anti-Depressants; Fusion; psychological disorders; Spine surgery

Cite the article

Jakoi A, D’Oro A, Buser Z, Friedl M, Wang JC. Assessing the Correlation between Lumbar Spine Surgery and Mental Health Disorders. Clin Surg. 2020; 5: 2811..