Influence of Preoperative Depression on Cervical Spine Surgery Outcomes: A Systematic Review and Meta-Analysis

作者：Saad Javeed, Salim Yakdan, Braeden Benedict, Samia Saleem, Muhammad Kaleem, Justin K. Zhang, Madelyn Frumkin, Angela Hardi, Brian J. Neuman, Michael P. Kelly, Burel R. Goodin, Thomas L. Rodebaugh, Wilson Z. Ray, Jacob K. Greenberg · 发表于：Global Spine Journal · 年份：2025 · DOI：10.1177/21925682251316245 · 被引用次数：16 · 研究领域：Spine and Intervertebral Disc Pathology、Cervical and Thoracic Myelopathy、Pelvic and Acetabular Injuries

Study Design Systematic review and Meta-analysis. Objectives To quantify the association of preoperative depression on patient reported outcome measures (PROMS) after cervical spine surgery. Methods We systematically searched PubMed, Cochrane, Embase, Scopus, PsychInfo, Web of Science, and ClinicalTrials.gov until September 14, 2023. Studies including adults undergoing cervical spine surgery and comparing PROMs between depressed and non-depressed patients were included. The primary outcome was the postoperative change in disability, pain, and physical function. Secondary outcomes included absolute disease severity before and after surgery. We conducted random-effects meta-analysis. Results After screening 3813 articles, 20 studies were included, encompassing 3964 patients (mean age 57, 51% males) with median follow-up duration of 12 months. There was significant heterogeneity in estimates of the primary outcome ( I 2 = 81%). While patients with depression had a greater magnitude of improvement compared with patients without depression, it was not statistically significant (SMD = 0.04, [95% CI: −0.07, 0.16], I 2 = 80%; P = 0.48). However, patients with depression exhibited worse absolute disease severity preoperatively (SMD = −0.31, [-0.44, −0.19], I 2 = 84%; P < 0.001) and postoperatively (SMD = −0.31, [−0.48, −0.15], I 2 = 89%; P < 0.002). Sensitivity analyses with meta-regression found that older age, sex (male-to-female ratio), percentage of comorbidities, study quality, f...