{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,30]],"date-time":"2026-10-30T03:23:40Z","timestamp":1793330620975,"version":"4.5.0"},"reference-count":32,"publisher":"SAGE Publications","issue":"4","license":[{"start":{"date-parts":[[2015,8,10]],"date-time":"2015-08-10T00:00:00Z","timestamp":1439164800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Global Spine Journal"],"published-print":{"date-parts":[[2016,6]]},"abstract":"<jats:sec>\n                    <jats:title>Study Design<\/jats:title>\n                    <jats:p>Retrospective cohort study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>We sought to assess the predictive value of preoperative depression and health state on 1-year quality-of-life outcomes after anterior cervical diskectomy and fusion (ACDF).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We analyzed 106 patients who underwent ACDF. All patients had either bilateral or unilateral cervical radiculopathy. Preoperative and 1-year postoperative health outcomes were assessed based on the visual analog scale, Pain Disability Questionnaire (PDQ), Patient Health Questionnaire (PHQ-9), and EuroQol-5 Dimensions (EQ-5D) questionnaire. Univariable and multivariate regression analyses were performed to assess for preoperative predictors of 1-year change in health status according to the EQ-5D.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Compared with preoperative health states, the ACDF cohort showed statistically significant improved PDQ (78.5 versus 57.9), PHQ-9 (9.7 versus 5.3), and EQ-5D (0.55 versus 0.68) scores at 1 year postoperatively and surpassed the minimum clinically important difference for the EQ-5D of 0.1 units (all p \u2264 0.01). Multivariate linear regression indicated that anxiolytic use and higher EQ-5D preoperative scores were associated with less 1-year postoperative improvement in health status. Although not statistically significant, clinically important effects of preoperative depression, as measured by the PHQ-9, were observed on postoperative QOL outcome (\u22120.006, 95% confidence interval \u22120.014 to 0.001).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Of patients who undergo ACDF with similar preoperative QOL health states, those with a greater degree of depression may have lower improvements in postoperative QOL compared with those with less depression. Patients with anxiety and better preoperative health states also attain less 1-year QOL improvements.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1055\/s-0035-1562932","type":"journal-article","created":{"date-parts":[[2015,8,10]],"date-time":"2015-08-10T18:43:01Z","timestamp":1439232181000},"page":"306-313","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":37,"title":["The Impact of Preoperative Depression and Health State on Quality-of-Life Outcomes after Anterior Cervical Diskectomy and Fusion"],"prefix":"10.1177","volume":"6","author":[{"given":"Matthew D.","family":"Alvin","sequence":"first","affiliation":[{"name":"Cleveland Clinic Center for Spine Health, Cleveland Clinic, Cleveland, Ohio, United States"},{"name":"Case Western Reserve University School of Medicine, Cleveland, Ohio, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jacob A.","family":"Miller","sequence":"additional","affiliation":[{"name":"Cleveland Clinic Center for Spine Health, Cleveland Clinic, Cleveland, Ohio, United States"},{"name":"Cleveland Clinic Lerner College of Medicine, Cleveland, Ohio, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Lubelski","sequence":"additional","affiliation":[{"name":"Cleveland Clinic Center for Spine Health, Cleveland Clinic, Cleveland, Ohio, United States"},{"name":"Cleveland Clinic Lerner College of Medicine, Cleveland, Ohio, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amy S.","family":"Nowacki","sequence":"additional","affiliation":[{"name":"Cleveland Clinic Lerner College of Medicine, Cleveland, Ohio, United States"},{"name":"Department of Quantitative Health Sciences, Cleveland Clinic, Cleveland, Ohio, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Judith","family":"Scheman","sequence":"additional","affiliation":[{"name":"Cleveland Clinic Center for Spine Health, Cleveland Clinic, Cleveland, Ohio, United States"},{"name":"Neurological Center for Pain, Cleveland Clinic, Cleveland, Ohio, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manu","family":"Mathews","sequence":"additional","affiliation":[{"name":"Neurological Center for Pain, Cleveland Clinic, Cleveland, Ohio, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew J.","family":"McGirt","sequence":"additional","affiliation":[{"name":"Carolina Neurosurgery and Spine Associates, Charlotte, North Carolina, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edward C.","family":"Benzel","sequence":"additional","affiliation":[{"name":"Cleveland Clinic Center for Spine Health, Cleveland Clinic, Cleveland, Ohio, United States"},{"name":"Cleveland Clinic Lerner College of Medicine, Cleveland, Ohio, United States"},{"name":"Department of Neurological Surgery, Cleveland Clinic, Cleveland, Ohio, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas E.","family":"Mroz","sequence":"additional","affiliation":[{"name":"Cleveland Clinic Center for Spine Health, Cleveland Clinic, Cleveland, Ohio, United States"},{"name":"Cleveland Clinic Lerner College of Medicine, Cleveland, Ohio, United States"},{"name":"Department of Neurological Surgery, Cleveland Clinic, Cleveland, Ohio, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2015,8,10]]},"reference":[{"key":"bibr1-s-0035-1562932","doi-asserted-by":"publisher","DOI":"10.1097\/BRS.0b013e318273aee2"},{"key":"bibr2-s-0035-1562932","doi-asserted-by":"publisher","DOI":"10.1016\/j.pmr.2010.12.001"},{"key":"bibr3-s-0035-1562932","doi-asserted-by":"publisher","DOI":"10.1055\/s-2008-1081201"},{"key":"bibr4-s-0035-1562932","doi-asserted-by":"publisher","DOI":"10.3171\/2012.10.SPINE12312"},{"key":"bibr5-s-0035-1562932","doi-asserted-by":"publisher","DOI":"10.1016\/S0090-3019(00)00201-9"},{"key":"bibr6-s-0035-1562932","doi-asserted-by":"publisher","DOI":"10.1007\/s00586-003-0530-2"},{"key":"bibr7-s-0035-1562932","doi-asserted-by":"publisher","DOI":"10.1007\/s00701-005-0660-x"},{"key":"bibr8-s-0035-1562932","doi-asserted-by":"publisher","DOI":"10.1007\/s00586-007-0560-2"},{"key":"bibr9-s-0035-1562932","doi-asserted-by":"publisher","DOI":"10.1097\/00007632-200010150-00012"},{"key":"bibr10-s-0035-1562932","doi-asserted-by":"publisher","DOI":"10.1016\/j.spinee.2004.08.004"},{"key":"bibr11-s-0035-1562932","doi-asserted-by":"publisher","DOI":"10.1097\/00007632-199709010-00018"},{"key":"bibr12-s-0035-1562932","doi-asserted-by":"publisher","DOI":"10.1097\/01.brs.0000231727.88477.da"},{"key":"bibr13-s-0035-1562932","doi-asserted-by":"publisher","DOI":"10.1067\/mem.2001.118863"},{"key":"bibr14-s-0035-1562932","doi-asserted-by":"publisher","DOI":"10.1016\/j.spinee.2013.01.017"},{"key":"bibr15-s-0035-1562932","doi-asserted-by":"publisher","DOI":"10.1016\/j.spinee.2011.08.014"},{"key":"bibr16-s-0035-1562932","doi-asserted-by":"publisher","DOI":"10.1007\/s10926-005-9005-0"},{"key":"bibr17-s-0035-1562932","doi-asserted-by":"publisher","DOI":"10.1001\/jama.282.18.1737"},{"key":"bibr18-s-0035-1562932","doi-asserted-by":"publisher","DOI":"10.1067\/mob.2000.106580"},{"key":"bibr19-s-0035-1562932","doi-asserted-by":"publisher","DOI":"10.2165\/00019053-199813040-00005"},{"key":"bibr20-s-0035-1562932","doi-asserted-by":"publisher","DOI":"10.1007\/s00134-001-1137-x"},{"key":"bibr21-s-0035-1562932","doi-asserted-by":"publisher","DOI":"10.1302\/0301-620X.91B2.21119"},{"key":"bibr22-s-0035-1562932","unstructured":"Wilson 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