OBJECTIVE The purpose of this study was to investigate the association between positive change in depression or anxiety within three months post-operation and clinically meaningful changes in long-term clinical outcomes after lumbar spine surgery. METHODS This study included adults with preoperative diagnosis of depression or anxiety who underwent lumbar spine surgery in the Quality Outcomes Database (QOD) from 2012 to 2018 with either a 12- or 24-month follow-up. Positive change in depression and anxiety was assessed three months after surgery. Clinical outcomes measured included Numeric Rating Scale (NRS) score for back pain (BP) and leg pain (LP), Oswestry Disability Index score (ODI) for disability, EuroQol Visual Analog Scale score (EQ-VAS) for health-related quality of life (HRQOL), and North American Spine Surgery (NASS) index score for patient satiaction measured at 12- and 24 months after surgery. RESULTS Of the 9,656 and 1,393 patients who were included in the 12- and 24-month cohort, respectively, 7,277 patients (75.4 %) and 1,089 (78.2 %) experienced a positive change in depression or anxiety within three months after surgery. At both 12- and 24-month follow-up, patients who had positive change in depression or anxiety were more likely to achieve minimal clinically important changes in NRS-BP/LP, ODI, EQ-VAS, and NASS (all p < 0.01) compared to those who did not experience improvement in depression or anxiety. CONCLUSION Depression and anxiety are important comorbidities to consider in patients undergoing lumbar spine surgery. Positive change in depression and anxiety are associated with improvements in pain, disability, satisfaction, and overall functioning.

中文翻译：

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术前抑郁/焦虑的变化对腰椎手术后患者预后的影响

目的 本研究的目的是调查术后三个月内抑郁或焦虑的积极变化与腰椎手术后长期临床结果的有临床意义的变化之间的关联。方法 本研究纳入了术前诊断为抑郁或焦虑的成年人，他们在质量结果数据库 (QOD) 中于 2012 年至 2018 年期间接受了腰椎手术，并进行了 12 个月或 24 个月的随访。手术后三个月评估抑郁和焦虑的积极变化。测量的临床结果包括背痛 (BP) 和腿痛 (LP) 的数字评定量表 (NRS) 评分、残疾的 Oswestry 残疾指数 (ODI)、EuroQol 视觉模拟量表评分 (EQ-VAS) 的健康相关质量生活（HRQOL），在手术后 12 个月和 24 个月测量的患者饱腹感的北美脊柱外科 (NASS) 指数评分。结果 在分别纳入 12 个月和 24 个月队列的 9,656 名和 1,393 名患者中，7,277 名患者 (75.4 %) 和 1,089 名 (78.2 %) 在手术后三个月内出现了抑郁或焦虑的积极变化。在 12 个月和 24 个月的随访中，抑郁或焦虑有积极变化的患者更有可能在 NRS-BP/LP、ODI、EQ-VAS 和 NASS 方面实现最小的临床重要变化（所有 p < 0.01 ) 与那些抑郁或焦虑没有改善的人相比。结论 抑郁和焦虑是腰椎手术患者需要考虑的重要合并症。抑郁和焦虑的积极变化与疼痛的改善有关，