title: The relationship between preoperative general mental health and postoperative quality of life in minimally invasive lumbar spine surgery.
abstract: BACKGROUND
  In assessing poor lumbar surgery outcomes, researchers continue to investigate psychosocial predictors of patient postoperative quality of life. This is the first study of its kind to investigate this relationship in an exclusively minimally invasive patient sample.
  
  
  OBJECTIVE
  To determine the association between preoperative mental health and postoperative patient-centered outcomes in patients undergoing minimally invasive lumbar surgery.
  
  
  METHODS
  In 83 adults undergoing single-level minimally invasive lumbar spine surgery, Pearson correlation and partial correlation analyses were conducted between all demographic and clinical baseline variables and Oswestry Disability Index (ODI), Visual Analogue Scale (VAS), and 36-item Short-Form Health Survey Version 2.0 (SF-36v2) scores at 6 to 12 months postoperatively. SF-36v2 mental component summary scores (MCS) were used to assess pre- and postoperative general mental health. Post hoc analysis consisted of Pearson correlations between baseline SF-36v2, ODI, and VAS scores, and an identical set of correlations at outcomes.
  
  
  RESULTS
  Preoperative MCS showed no significant association with outcomes VAS, ODI, or physical component summary scores. Baseline disability correlated significantly and more strongly with baseline MCS (P < .001, r = -0.40) than baseline pain levels (VAS back not significant, VAS leg P = .015, r = 0.27). Outcomes disability correlated significantly and more strongly with outcome back and leg pain levels (P < .001, r = 0.60 and 0.66) than outcome MCS (P = .031, r = -0.24).
  
  
  CONCLUSIONS
  In a patient sample with mental health scores comparable to the population mean, there is no relationship between preoperative general mental health and postoperative patient-centered outcomes. Surgeons should consider the dynamic relationships between patient disability, mental health, and pain levels in assessing quality of life at different time points.
authors.affiliation: *Department of Neurological Surgery, Rush University Medical Center, Chicago, Illinois; ‡Osher Center for Integrative Medicine, Department of Medicine, University of California at San Francisco, San Francisco, California; §Northwestern University Feinberg School of Medicine, Chicago, Illinois.
authors.forename: Rachel
authors.initials: R
authors.lastname: Asher
authors.forename: Ashley E
authors.initials: AE
authors.lastname: Mason
authors.forename: Joseph
authors.initials: J
authors.lastname: Weiner
authors.forename: Richard G
authors.initials: RG
authors.lastname: Fessler
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004185:Disability Evaluation; D005260:Female; D006306:Health Surveys; D006801:Humans; D008159:Lumbar Vertebrae / Q000601:surgery; D008297:Male; D008603:Mental Health; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures; D017063:Outcome Assessment, Health Care; D011184:Postoperative Period; D011788:Quality of Life; D013130:Spinal Stenosis / Q000523:psychology* / Q000601:surgery*; D016896:Treatment Outcome