Anxiety and depression 1-year after spinal tumour surgery: a retrospective analysis of psychological and clinical predictors.

PURPOSE: To assess the predictive value of pre-operative psychiatric and surgical history on anxiety and depression 12 months following spine tumour surgery.

METHODS

A retrospective cohort study with 119 adult spine tumour patients treated at a large UK Quaternary Spinal Surgical Unit. All patients completed EQ-5D-5L and VAS patient-reported outcome measures via the British Spine Registry (BSR). Demographics and clinical outcomes were collected from patient medical records. Multiple linear regression was used to examine the predictive value of clinical variables on 12-month follow-up anxiety and depression. Spearman’s Rho correlations and chi-square tests for association were performed to further understand relationships.

RESULTS

The regression model was statistically significant (F(12, 101) = 3.27, p < .001). Gender (β = 0.182, p.41), mental health history (β=-0.316, p < .001), number of previous surgeries (β = 0.235, p.030) and baseline EQ-5D-5L utility index scores (β = 0.271, p.005) were significant predictors of 12-month anxiety and depression. However, the overall model accounted for only a modest proportion of variance (R²=0.28 and R²adjusted = 0.19). Spearman’s Rho correlations showed baseline and 12-month follow-up EQ-5D-5L anxiety and depression significantly correlated (rs=.24, n=119, p=.008). Baseline EQ-5D-5L anxiety and depression scores had a significant correlation with baseline VAS back (rs=.20, n=119, p=.043) and leg pain (rs=.31, n=119, p=.002) and follow-up back pain (rs=.12, n=119, p=.031). A chi-squared test showed a significant association between a pre-existing mental health diagnosis and mood disturbance (Χ2(2) = 8.58, p =.014). 67.9% of the deteriorated mood cohort had no pre-existing mental health diagnosis, no previous surgeries and were attending for an index operation.

CONCLUSION

Pre-existing psychiatric diagnoses and surgical history modestly predicted anxiety and depression following spinal tumour surgery, but most patients with deteriorated mood had no prior mental health history. These findings support integrating routine psychological screening before surgery to identify emotionally vulnerable patients early. Stepped approaches beginning with routine PROMs may improve timely identification of at-risk patients and support ongoing monitoring. Keywords: spinal tumour, mental health, psychological screening, pain, surgical outcomes