Cha Elliot D K, Lynch Conor P, Parrish James M, Jenkins Nathaniel W, Geoghegan Cara E, Jadczak Caroline N, Mohan Shruthi, Singh Kern
Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL, USA.
Neurospine. 2021 Mar;18(1):217-225. doi: 10.14245/ns.2040610.305. Epub 2021 Mar 31.
There is a scarcity of research evaluating gender differences in depressive symptoms among patients undergoing cervical surgery. This study investigated gender differences with regard to depressive symptom severity, measured by Patient Health Questionnaire-9 (PHQ-9), in patients following anterior cervical discectomy and fusion (ACDF) or artificial disc replacement (ADR).
A prospectively maintained surgical registry was retrospectively reviewed for eligible spine surgeries. Depressive symptom severity was evaluated by PHQ-9 at both preand postoperative timepoints (e.g. , 6 weeks, 12 weeks, 6 months, 1 year, and 2 years). A chi-square test and Student t-test evaluated differences between the gender for demographic and operative variables where appropriate. Differences between the gender subgroup mean PHQ-9 scores were assessed using a t-test pre- and postoperatively (e.g. , 6 weeks, 12 weeks, 6 months, and 1 year) and a paired t-test was used to assess differences from preoperative scores at each postoperative time point.
A total of 170 subjects underwent 125 ACDFs and 45 ADRs. Both pre- and postoperative timepoints demonstrated no significant differences between mean PHQ-9 scores by gender. Female patients demonstrated statistically significant improvement in PHQ-9 scores at 6 weeks, and 12 weeks, but not through 2 years. Male patients demonstrated statistically significant improvement in PHQ-9 scores at 6 weeks, 12 weeks, 6 months, 1 year, and 2 years.
Although there were no significant differences between mean PHQ-9 score between the genders, there was a difference in magnitude of improvement. Females had a significant improvement in depressive symptom severity over baseline at the 6- and 12-week timepoints only, whereas males had significant improvement through 2 years postoperatively.
评估接受颈椎手术患者抑郁症状性别差异的研究较少。本研究调查了接受颈椎前路椎间盘切除融合术（ACDF）或人工椎间盘置换术（ADR）的患者，以患者健康问卷-9（PHQ-9）测量的抑郁症状严重程度方面的性别差异。
对前瞻性维护的手术登记册进行回顾，以确定符合条件的脊柱手术。在术前和术后时间点（如6周、12周、6个月、1年和2年）通过PHQ-9评估抑郁症状严重程度。在适当情况下，使用卡方检验和学生t检验评估性别在人口统计学和手术变量方面的差异。术前和术后（如6周、12周、6个月和1年）使用t检验评估性别亚组平均PHQ-9得分之间的差异，并使用配对t检验评估每个术后时间点与术前得分的差异。
共有170名受试者接受了125例ACDF手术和45例ADR手术。术前和术后时间点，按性别划分的平均PHQ-9得分均无显著差异。女性患者在6周和12周时PHQ-9得分有统计学显著改善，但2年时未改善。男性患者在6周、12周、6个月、1年和2年时PHQ-9得分有统计学显著改善。
尽管性别之间的平均PHQ-9得分没有显著差异，但改善程度存在差异。女性仅在6周和12周时间点抑郁症状严重程度较基线有显著改善，而男性术后2年都有显著改善。
