Lynch Conor P, Cha Elliot D K, Jenkins Nathaniel W, Parrish James M, Geoghegan Cara E, Jadczak Caroline N, Mohan Shruthi, Singh Kern
Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL, USA.
Neurospine. 2021 Jun;18(2):369-376. doi: 10.14245/ns.2142162.031. Epub 2021 Jun 30.
The Patient Health Questionnaire-9 (PHQ-9) is a screening tool for evaluating depressive symptoms. Research is scarce regarding the validity and correlation of PHQ-9 scores with other patient-reported outcomes of mental health after minimally invasive lumbar discectomy (MIS LD). We aim to validate PHQ-9 as a metric for assessing mental health in MIS LD patients.
A database was retrospectively reviewed for patients who underwent elective, single-level MIS LD. Patients were excluded if they had incomplete preoperative PHQ-9, 12-item Short Form Health Survey (SF-12), or Veterans RAND 12-item health survey (VR12). Survey scores were collected preoperatively and postoperatively through 1 year. Mean scores were used to calculate postoperative improvement from preoperative scores. Correlation of PHQ-9 with SF-12 mental composite score (MCS) and VR-12 MCS scores was also calculated. Correlation strength was assessed by the following categories: 0.1 ≤ |r| < 0.3 = low; 0.3 ≤ |r| < 0.5 = moderate; |r| ≥ 0.5 = strong.
A total of 239 patients underwent single-level MIS LD. PHQ-9, VR-12 MCS, and SF-12 MCS all demonstrated statistically significant increases from preoperative scores at all postoperative timepoints (p ≤ 0.001). SF-12 MCS and VR-12 MCS were each observed to have strong and significant correlations with PHQ-9 at all timepoints when evaluated with both Pearson correlation coefficients and partial correlation coefficients.
We observed that PHQ-9, SF-12 MCS and VR-12 MCS all significantly improve following lumbar discectomy and that PHQ-9 scores strongly correlated with these previously established measures. Our results substantiate evidence from other surgical fields that PHQ-9 scores are a valid tool to evaluate pre- and postsurgical depressive symptoms.
患者健康问卷-9（PHQ-9）是一种用于评估抑郁症状的筛查工具。关于PHQ-9评分在微创腰椎间盘切除术（MIS LD）后与其他患者报告的心理健康结果之间的有效性和相关性的研究较少。我们旨在验证PHQ-9作为评估MIS LD患者心理健康指标的有效性。
对接受择期单节段MIS LD的患者数据库进行回顾性分析。如果患者术前PHQ-9、12项简短健康调查（SF-12）或退伍军人兰德12项健康调查（VR12）不完整，则将其排除。术前和术后1年内收集调查评分。平均评分用于计算术后相对于术前评分的改善情况。还计算了PHQ-9与SF-12心理综合评分（MCS）和VR-12 MCS评分之间的相关性。相关性强度按以下类别评估：0.1≤|r|<0.3 = 低；0.3≤|r|<0.5 = 中等；|r|≥0.5 = 强。
共有239例患者接受了单节段MIS LD。PHQ-9、VR-12 MCS和SF-12 MCS在所有术后时间点的评分均较术前有统计学显著提高（p≤0.001）。在用Pearson相关系数和偏相关系数评估时，SF-12 MCS和VR-12 MCS在所有时间点均与PHQ-9有强且显著的相关性。
我们观察到PHQ-9、SF-12 MCS和VR-12 MCS在腰椎间盘切除术后均有显著改善，且PHQ-9评分与这些先前确立的指标密切相关。我们的结果证实了其他外科领域的证据，即PHQ-9评分是评估手术前后抑郁症状的有效工具。
