The Impact of Major Depressive Disorder on Somatic and Psychiatric Outcomes Following Elective Single-Level Lumbar Fusion: A Propensity Score-Matched Analysis
Abstract
Study Design Retrospective database study. Objective Major depressive disorder (MDD) is common psychiatric comorbidity among lumbar fusion candidates, yet its association with postoperative psychiatric and somatic symptoms morbidity and healthcare utilization remains inadequately characterized. This study evaluated whether preoperative MDD increases the risk of adverse psychiatric and medical outcomes following single-level lumbar fusion. Methods Utilizing a national electronic health record network, adults undergoing elective single-level lumbar fusion between 2015 and 2025 were identified. Patients with recurrent MDD diagnosed within 1-year preoperatively were compared with patients without MDD after one-to-one propensity score matching for demographics, comorbidities, laboratory values, and preoperative medications. Outcomes were assessed at 90-days and 1-year. Results The matched cohort included 11 570 patient pairs. Patients with MDD demonstrated higher rates of newly diagnosed psychiatric conditions at both time points, including generalized anxiety disorder, adjustment disorder, post-traumatic stress disorder, alcohol-use disorder, and dementia; opioid-use disorder was increased at 1 year. MDD was also associated with higher rates of postoperative somatic symptom diagnoses, including chest pain, dizziness, and shortness of breath. Emergency department utilization did not differ at 90 days but was higher at 1 year, while inpatient readmission rates were increased at both time points. There were no differences in reoperation rates or mortality between cohorts. Conclusions Preoperative MDD was associated with postoperative psychiatric morbidity, somatic symptoms, and increased healthcare utilization within 1 year following the procedure, without evidence of higher reoperation or mortality. These findings support routine depression screening and perioperative mental health optimization in single-level lumbar fusion candidates.
Related
- Comparative health outcomes of buprenorphine versus methadone treatment for opioid use disorder: a retrospective propensity score-matched cohort study in the global federated electronic health record network
- Physical Fitness Outcomes in Youth with Autism Spectrum Disorder Following Judo Training in Inclusive Settings with Neurotypical Peers
- Chronic Pain and Residual Limb Outcomes Following Primary Major Lower Extremity Amputation vs. Minor-to-Major Amputation Progression: A Propensity Score-Matched Analysis
- From caregiver burden to psychological resilience and positive emotional outcomes: the effectiveness of innovative psychiatric nursing intervention among family caregivers of patients with bipolar disorder.
- Association of type 2 diabetes mellitus with postoperative outcomes following single-level endoscopic lumbar interbody fusion through a posterior approach: A global propensity score–matched cohort study
BibTeX
@article{tummala2026impact,
title = {{The Impact of Major Depressive Disorder on Somatic and Psychiatric Outcomes Following Elective Single-Level Lumbar Fusion: A Propensity Score-Matched Analysis}},
author = {Sri Tummala BS and Hetsinhji Chavda BS and Tarun R. Sontam MD and David C. Gibbs MD and Ioannis Avramis MD and James M. Rizkalla MD},
journal = {Global Spine Journal},
year = {2026},
month = oct,
doi = {10.1177/21925682261445029},
url = {https://doi.org/10.1177/21925682261445029},
note = {CC BY},
}
RIS
TY - JOUR
TI - The Impact of Major Depressive Disorder on Somatic and Psychiatric Outcomes Following Elective Single-Level Lumbar Fusion: A Propensity Score-Matched Analysis
AU - Sri Tummala BS
AU - Hetsinhji Chavda BS
AU - Tarun R. Sontam MD
AU - David C. Gibbs MD
AU - Ioannis Avramis MD
AU - James M. Rizkalla MD
PY - 2026
DA - 2026/10/31
JO - Global Spine Journal
DO - 10.1177/21925682261445029
UR - https://doi.org/10.1177/21925682261445029
AB - Study Design Retrospective database study. Objective Major depressive disorder (MDD) is common psychiatric comorbidity among lumbar fusion candidates, yet its association with postoperative psychiatric and somatic symptoms morbidity and healthcare utilization remains inadequately characterized. This study evaluated whether preoperative MDD increases the risk of adverse psychiatric and medical outcomes following single-level lumbar fusion. Methods Utilizing a national electronic health record network, adults undergoing elective single-level lumbar fusion between 2015 and 2025 were identified. Patients with recurrent MDD diagnosed within 1-year preoperatively were compared with patients without MDD after one-to-one propensity score matching for demographics, comorbidities, laboratory values, and preoperative medications. Outcomes were assessed at 90-days and 1-year. Results The matched cohort included 11 570 patient pairs. Patients with MDD demonstrated higher rates of newly diagnosed psychiatric conditions at both time points, including generalized anxiety disorder, adjustment disorder, post-traumatic stress disorder, alcohol-use disorder, and dementia; opioid-use disorder was increased at 1 year. MDD was also associated with higher rates of postoperative somatic symptom diagnoses, including chest pain, dizziness, and shortness of breath. Emergency department utilization did not differ at 90 days but was higher at 1 year, while inpatient readmission rates were increased at both time points. There were no differences in reoperation rates or mortality between cohorts. Conclusions Preoperative MDD was associated with postoperative psychiatric morbidity, somatic symptoms, and increased healthcare utilization within 1 year following the procedure, without evidence of higher reoperation or mortality. These findings support routine depression screening and perioperative mental health optimization in single-level lumbar fusion candidates.
SN - 2192-5682
SN - 2192-5690
ER -