Heterogeneous influences of emotional disturbances on multi-domain quality of life after anterior cervical spine surgery: A prospective study

Objective: Quality of life (QoL) has been identified as one of the most important outcome measurements following cervical spine surgery. The contributing factors to post-operative QoL remain limited. This study thus aimed to prospectively examine the QoL and related pre-operative emotional factors in patients who underwent anterior cervical spine surgery. Patients and methods: A total of 124 patients who underwent anterior cervical spine surgery were recruited. All participants were prospectively evaluated for their QoL and 2 aspects of emotion, depression and anxiety, before and after surgery, respectively. Results: Pre-operatively, 13% of patients showed signs of depression and 31% of patients reported symptoms of anxiety. Post-operatively 14% of patients reported depression, but 41% reported symptoms of anxiety. A significant association between depression, anxiety and different domains of QoL were identified, and specific cut-off points of pre-operatively depressive and/or anxiety levels to predict unfavorable post-operative QoL were further established. Conclusions: This prospective study demonstrated specific emotional factors, specifically depression and anxiety, influence patients’ QoL following surgery. These results suggest clinicians should also monitor patients’ emotional adjustments with their physical conditions. ? 2019 Elsevier B.V.