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

Abstract 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.