Journal of clinical neuroscience : official journal of the Neurosurgical Society of Australasia · 2026
Impact of post-traumatic stress disorder on clinical outcomes following lumbar interbody spinal fusion.
СтатьяМногоцентровое исследованиеНазвание и аннотация: Перевод в очереди
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Silvestre Jason, Ferdon Robert J, Williams Michal A, Roth Warren, Ravinsky Robert A, Reitman Charles A
Аннотация
BACKGROUND: The purpose of this study was to investigate the association between post-traumatic stress disorder (PTSD) and adverse clinical events following lumbar interbody fusion surgery.
METHODS: A multi-institutional electronic medical record database was queried for patients undergoing lumbar interbody fusion surgery. The primary cohort of interest consisted of adult patients with a pre-operative diagnosis of PTSD. Propensity score matching was performed using demographics and comorbidities to generate matched controls. Patients with spine neoplasms, trauma, osteomyelitis, and inflammatory conditions were excluded. Short-term and long-term comparisons between cohorts were made with Chi-squared and independent t-tests.
RESULTS: After propensity matching, there were 2,572 patients included in this study, which were evenly distributed between the PTSD and control cohorts. At ninety-days, patients with PTSD demonstrated higher rates of opioid utilization (OR:1.8, 95% CI:1.2-2.7; P = 0.005) and emergency department utilization (OR:1.5, 95% CI:1.2-1.8; P < 0.001) compared to patients in the control group. There were similar rates of medical complications between the two groups at thirty- and ninety-days (P > 0.05). At two-years, patients in the PTSD cohort demonstrated similar rates of mortality (OR:1.0, 95% CI:0.5-2.2; P = 1.0) and lumbar spine reoperation (OR:0.9, 95% CI:0.7-1.2; P = 0.392) compared to patients in the control group.
CONCLUSIONS: Patients with PTSD demonstrated higher rates of emergency department utilization and opioid utilization following lumbar interbody fusion surgery. Additional research is needed to develop multi-disciplinary strategies to optimize clinical outcomes following lumbar spine surgery among patients with PTSD.
METHODS: A multi-institutional electronic medical record database was queried for patients undergoing lumbar interbody fusion surgery. The primary cohort of interest consisted of adult patients with a pre-operative diagnosis of PTSD. Propensity score matching was performed using demographics and comorbidities to generate matched controls. Patients with spine neoplasms, trauma, osteomyelitis, and inflammatory conditions were excluded. Short-term and long-term comparisons between cohorts were made with Chi-squared and independent t-tests.
RESULTS: After propensity matching, there were 2,572 patients included in this study, which were evenly distributed between the PTSD and control cohorts. At ninety-days, patients with PTSD demonstrated higher rates of opioid utilization (OR:1.8, 95% CI:1.2-2.7; P = 0.005) and emergency department utilization (OR:1.5, 95% CI:1.2-1.8; P < 0.001) compared to patients in the control group. There were similar rates of medical complications between the two groups at thirty- and ninety-days (P > 0.05). At two-years, patients in the PTSD cohort demonstrated similar rates of mortality (OR:1.0, 95% CI:0.5-2.2; P = 1.0) and lumbar spine reoperation (OR:0.9, 95% CI:0.7-1.2; P = 0.392) compared to patients in the control group.
CONCLUSIONS: Patients with PTSD demonstrated higher rates of emergency department utilization and opioid utilization following lumbar interbody fusion surgery. Additional research is needed to develop multi-disciplinary strategies to optimize clinical outcomes following lumbar spine surgery among patients with PTSD.