{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T04:58:28Z","timestamp":1785214708914,"version":"3.55.0"},"reference-count":23,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"4","license":[{"start":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:00:00Z","timestamp":1782864000000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2026,7]]},"abstract":"ABSTRACT<\/jats:title>\n \n Context:<\/jats:title>\n Psychiatric comorbidity has been associated with worse perioperative outcomes and greater healthcare utilization after spine surgery.<\/jats:p>\n <\/jats:sec>\n \n Aims:<\/jats:title>\n This study compared complications and healthcare utilization among posterior cervical decompression and fusion (PCDF) patients with depression, psychotic disorders, or no mental-health diagnosis.<\/jats:p>\n <\/jats:sec>\n \n Settings and Design:<\/jats:title>\n Retrospective cohort analysis of the National Inpatient Sample from 2016 to 2022.<\/jats:p>\n <\/jats:sec>\n \n Materials and Methods:<\/jats:title>\n The database was queried for elective adult PCDF encounters. Mental-health exposures were defined using Elixhauser indicators for depression and psychoses. Outcomes included medical complications, non-routine discharge, inpatient mortality, length of stay (LOS), and costs.<\/jats:p>\n <\/jats:sec>\n \n Statistical Analysis Used:<\/jats:title>\n \n Chi-square and multivariate logistic regression analyses were performed. Significance was set at the\n P<\/jats:italic>\n < 0.05 level.\n <\/jats:p>\n <\/jats:sec>\n \n Results:<\/jats:title>\n \n We identified 167,480 weighted admissions: 129,205 with no mental-health diagnosis, 32,500 with depression, and 5,775 with psychotic disorders. Depression was associated with higher odds of cardiovascular complications (odds ratio [OR]: 1.20,\n P<\/jats:italic>\n < 0.001), mechanical complications (OR: 1.24,\n P<\/jats:italic>\n < 0.001), a composite adverse-event outcome (OR: 1.17,\n P<\/jats:italic>\n < 0.001), and nonroutine discharge (OR: 1.12,\n P<\/jats:italic>\n < 0.001). Psychotic disorders were associated with higher odds of mechanical complications (OR: 1.44,\n P<\/jats:italic>\n = 0.002), nonroutine discharge (OR: 1.32,\n P<\/jats:italic>\n < 0.001), and inpatient mortality (OR: 2.33,\n P<\/jats:italic>\n = 0.043). Costs were higher with depression and highest with psychotic disorders ($39,564 vs. $40,787 vs. $42,362;\n P<\/jats:italic>\n < 0.001). LOS was higher with depression and highest with psychotic disorders (4.10 vs. 4.36 vs. 4.81 days;\n P<\/jats:italic>\n < 0.001).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions:<\/jats:title>\n Depression and psychotic disorders are common in PCDF and are linked to worse outcomes and higher resource use.<\/jats:p>\n <\/jats:sec>","DOI":"10.4103\/jcvjs.jcvjs_95_26","type":"journal-article","created":{"date-parts":[[2026,7,24]],"date-time":"2026-07-24T12:00:28Z","timestamp":1784894428000},"page":"434-440","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Depression and psychotic disorders elevate inpatient burden after posterior cervical decompression and fusion: Prioritizing screening and targeted discharge planning"],"prefix":"10.4103","volume":"17","author":[{"given":"Leonidas E.","family":"Mastrokostas","sequence":"first","affiliation":[{"name":"Department of Orthopaedic Surgery, SUNY Downstate Health Sciences University, Brooklyn, USA"},{"name":"Department of Orthopaedic Surgery, Maimonides Medical Center, Brooklyn, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul G.","family":"Mastrokostas","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Maimonides Medical Center, Brooklyn, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Yusupov","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, SUNY Downstate Health Sciences University, Brooklyn, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abigail","family":"Razi","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Maimonides Medical Center, Brooklyn, USA"},{"name":"Department of Orthopaedic Surgery, Donald and Barbara Zucker School of Medicine, Hempstead, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aaron B.","family":"Lavi","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, SUNY Downstate Health Sciences University, Brooklyn, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luke B.","family":"Schwartz","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, SUNY Downstate Health Sciences University, Brooklyn, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sean","family":"Inzerillo","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, SUNY Downstate Health Sciences University, Brooklyn, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohamed","family":"Said","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, SUNY Downstate Health Sciences University, Brooklyn, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander","family":"Kucherina","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, SUNY Downstate Health Sciences University, Brooklyn, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pemla","family":"Jagtiani","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Cooper University Health Care, Camden, NJ, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arie","family":"Monas","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Maimonides Medical Center, Brooklyn, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John K.","family":"Houten","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Mount Sinai School of Medicine, New York, NY, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher K.","family":"Kepler","sequence":"additional","affiliation":[{"name":"Rothman Orthopaedic Institute, Thomas Jefferson University Hospital, Philadelphia, PA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jad Bou","family":"Monsef","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, SUNY Downstate Health Sciences University, Brooklyn, USA"},{"name":"Department of Orthopaedic Surgery, Maimonides Medical Center, Brooklyn, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Afshin E.","family":"Razi","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Maimonides Medical Center, Brooklyn, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mitchell K.","family":"Ng","sequence":"additional","affiliation":[{"name":"Rothman Orthopaedic Institute, Thomas Jefferson University Hospital, Philadelphia, PA, 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increases posterior cervical decompression and fusion revision rates and diminishes neck disability index improvement","volume":"47","author":"Toci","year":"2022","journal-title":"Spine (Phila Pa 1976)"},{"key":"R16-20260728","doi-asserted-by":"crossref","first-page":"2767","DOI":"10.1177\/21925682251316245","article-title":"Influence of preoperative depression on cervical spine surgery outcomes: A systematic review and meta-analysis","volume":"15","author":"Javeed","year":"2025","journal-title":"Global Spine J"},{"key":"R17-20260728","doi-asserted-by":"crossref","first-page":"11","DOI":"10.3171\/2023.2.SPINE22685","article-title":"Do comorbid self-reported depression and anxiety influence outcomes following surgery for cervical spondylotic myelopathy?","volume":"39","author":"Chan","year":"2023","journal-title":"J Neurosurg Spine"},{"key":"R18-20260728","doi-asserted-by":"crossref","first-page":"E472","DOI":"10.1097\/BSD.0000000000000957","article-title":"The impact of multiple 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opioid use after cervical spine fusion: An analysis of a national claims database","volume":"47","author":"Makanji","year":"2024","journal-title":"Orthopedics"}],"container-title":["Journal of Craniovertebral Junction and Spine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.lww.com\/10.4103\/jcvjs.jcvjs_95_26","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T04:00:24Z","timestamp":1785211224000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.lww.com\/10.4103\/jcvjs.jcvjs_95_26"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7]]},"references-count":23,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2026]]}},"URL":"https:\/\/doi.org\/10.4103\/jcvjs.jcvjs_95_26","relation":{},"ISSN":["0974-8237","0976-9285"],"issn-type":[{"value":"0974-8237","type":"print"},{"value":"0976-9285","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7]]},"assertion":[{"value":"2026-04-30","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-06-24","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}