The Influence of Preoperative Psychological States on Postoperative Outcomes Following Percutaneous Kyphoplasty(PKP)

Abstract Background: Psychological disorder is widespread in patients with spinal conditions. There is limited investigation into the association between preoperative psychological symptoms(PPS) and postoperative outcomes following percutaneous kyphoplasty(PKP) in patients suffered osteoporotic vertebral compression fracture(OVCF) . Methods: This is a retrospective study performed on 224 patients undergoing PKP due to OVCF. Patients are divided into two cohorts base on preoperative psychological states described by Hamilton Depression Scale(HAMD) and Hamilton Anxiety Scale(HAMA). Pre- and postoperative physical function were evaluated by Patient-Reported Outcome Measurement Information System Physical Function(PROMIS PF), and Visual Analogue Scales(VAS) was used to to evaluate patients' back pain. Multiple linear regression model was used to investigate the association between preoperative psychological symptoms and postoperative outcomes.Results: 133(59.4%) patients have PPS, manifested as HAMD score ≥7 and/or HAMA score＞7. Patients with PPS have significantly worse PROMIS PF scores preoperatively (26.6±7.6 vs. 34.2±6.9, p=0.000), as well as within 6 monthes postoperatively, 1-week (31.1±6.5 vs. 37.4±7.2, p=0.000), 1-month (35.3±6.2 vs. 41.1±7.4, p=0.023), 3-months (38.5±8.3 vs. 45.8±8.5, p=0.005), and 6-months (42.8±8.0 vs. 51.2±9.1, p=0.000). Patients with PPS have higher VAS scores preoperatively(8.3±1.6 vs. 6.9±1.9, p=0.001), as well as within 1 month following operation, 1-week (6.2±1.7 vs. 4.1±1.2, p=0.000), 1-month (4.0±1.1 vs. 2.5±1.0, p=0.015).Conclusion: Psychological symptoms are widespread in OVCF patients undergoing PKP. Patients with poor preoperative psychological states not only demonstrated worse preoperative physical function and back pain, but also continued to have significantly worse postoperative outcomes.