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A Validation of Patient Health Questionnaire-9 for Cervical Spine Surgery.
Spine 2020 August 2
STUDY DESIGN: Retrospective.
OBJECTIVE: The purpose of this study is to evaluate depressive symptoms as measured by the PHQ-9 survey and correlated them with scores from the SF-12 and VR-12 Mental Component Summary (MCS).
SUMMARY OF BACKGROUND DATA: With the rising incidence of depression and the need to identify modifiable risk factors before surgery, it is increasingly important to screen for preoperative depressive symptoms in spine surgery. While the Patient Health Questionnaire-9 (PHQ-9) has favorable characteristics as a depressive symptom screening instrument, it has not been evaluated within cervical spine surgery.
METHODS: A prospectively maintained surgical registry was reviewed for patients undergoing single or multilevel anterior cervical discectomy and fusion (ACDF) or cervical disc replacement (CDR) from March 2016 until May 2019. Included patients underwent a procedure for degenerative spinal pathology. We collected demographic, baseline, and perioperative variables. The mean scores for postoperative PHQ-9, Short Form-12 (SF-12), and Veterans RAND-12 (VR-12) surveys were calculated, and an average change between preoperative and postoperative scores. Scatterplots depicted the association of SF-12 MCS and VR-12 MCS with PHQ-9. We evaluated the relationship of PHQ-9 with SF-12 MCS and VR-12 MCS scores by calculating a Pearson's correlation coefficient and time-independent partial correlation coefficient.
RESULTS: 152 patients underwent single or multilevel level cervical spine surgery (ACDF: 73% and CDR: 27%). The average age was 42.4 and 39% were female. Compared to preoperative scores, significant increases were observed among postoperative PHQ-9, SF-12, and VR-12 MCS surveys (p≤0.001). We observed strong correlations between SF-12 and VR-12 MCS with PHQ-9 scores for both assessed correlations.
CONCLUSION: Patients undergoing ACDF or CDR demonstrated significant improvement with PHQ-9, SF-12 MCS and VR-12 MCS instruments. PHQ-9 scores strongly correlated with SF-12 MCS and VR-12 MCS. Our findings indicate PHQ-9 is a valid tool to evaluate pre and postsurgical depressive symptoms.
LEVEL OF EVIDENCE: 4.
OBJECTIVE: The purpose of this study is to evaluate depressive symptoms as measured by the PHQ-9 survey and correlated them with scores from the SF-12 and VR-12 Mental Component Summary (MCS).
SUMMARY OF BACKGROUND DATA: With the rising incidence of depression and the need to identify modifiable risk factors before surgery, it is increasingly important to screen for preoperative depressive symptoms in spine surgery. While the Patient Health Questionnaire-9 (PHQ-9) has favorable characteristics as a depressive symptom screening instrument, it has not been evaluated within cervical spine surgery.
METHODS: A prospectively maintained surgical registry was reviewed for patients undergoing single or multilevel anterior cervical discectomy and fusion (ACDF) or cervical disc replacement (CDR) from March 2016 until May 2019. Included patients underwent a procedure for degenerative spinal pathology. We collected demographic, baseline, and perioperative variables. The mean scores for postoperative PHQ-9, Short Form-12 (SF-12), and Veterans RAND-12 (VR-12) surveys were calculated, and an average change between preoperative and postoperative scores. Scatterplots depicted the association of SF-12 MCS and VR-12 MCS with PHQ-9. We evaluated the relationship of PHQ-9 with SF-12 MCS and VR-12 MCS scores by calculating a Pearson's correlation coefficient and time-independent partial correlation coefficient.
RESULTS: 152 patients underwent single or multilevel level cervical spine surgery (ACDF: 73% and CDR: 27%). The average age was 42.4 and 39% were female. Compared to preoperative scores, significant increases were observed among postoperative PHQ-9, SF-12, and VR-12 MCS surveys (p≤0.001). We observed strong correlations between SF-12 and VR-12 MCS with PHQ-9 scores for both assessed correlations.
CONCLUSION: Patients undergoing ACDF or CDR demonstrated significant improvement with PHQ-9, SF-12 MCS and VR-12 MCS instruments. PHQ-9 scores strongly correlated with SF-12 MCS and VR-12 MCS. Our findings indicate PHQ-9 is a valid tool to evaluate pre and postsurgical depressive symptoms.
LEVEL OF EVIDENCE: 4.
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