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Fusion Surgery

Pre-Operative Mental Health as a Predictor of Post-Operative Psychological Wellbeing

Teaser: 

Katie Applegarth, BSc Candidate,1 Morgan Tidler, BSc Candidate,2 Emily K Schaeffer, PhD,3 Caitlyn Dunphy, MPT,4 Andrea Mary Simmonds, MD, MHSc, FRCS(C),5

1University of British Columbia, Department of Orthopaedic Surgery, BC Children’s Hospital
2University of British Columbia, Department of Orthopaedic Surgery, BC Children’s Hospital
3University of British Columbia, BC Children’s Hospital
4BC Children’s Hospital
5University of British Columbia, Department of Orthopaedic Surgery, BC Children’s Hospital


CLINICAL TOOLS

Abstract: Patients undergoing fusion surgery for adolescent idiopathic scoliosis often experience significant psychological distress. The aim of this scoping review was to synthesize existing evidence to clarify the relationship between pre-operative mental health and post-operative psychological function. From an original 1616 studies identified by the database search, nine studies met the inclusion criteria. These grouped into four mental health categories: mental health disorders, pain catastrophizing, predictors of post-operative mental health, and psychological interventions. This scoping review identified a prominent connection between pre-operative and post-operative mental health scores. These findings encourage the use of pre-operative psychological assessments and recommend future research related to perioperative psychological interventions.
Key Words: Adolescent Idiopathic Scoliosis (AIS), Fusion Surgery, Mental Health, Psychological Wellbeing.

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Pre-test CME Quiz Post-test CME Quiz
1. Poor pre-operative mental health is a predictor of poor post-operative psychological wellbeing.
2. Pre-operative assessments can be used to help identify patients who would benefit from extra support.
3. Psychological interventions may help mitigate poor perioperative psychological function.
4. Psychological function improved by 2-year post-operative follow-up.
Pre-operative psychological assessments and surveys can help identify patients with poorer mental health scores. Identified patients can be provided with psychological interventions or coping strategies to help mitigate poor perioperative psychological function.
Patients with poor pre-operative mental health scores should be monitored post-operatively to ensure smooth post-operative recovery.
Psychological interventions and coping strategies should be tailored to best fit the personal preference of patients. Ongoing research should continue to be conducted regarding the efficacy of different perioperative interventions and coping strategies.
Psychological function may decrease in the immediate post-operative period, but then improves by 2-year post-operative follow-up. This suggests that perioperative stress may contribute to temporary decreases in psychological function.
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Related Terms: Back Health, Adolescent Idiopathic Scoliosis, mental health, Fusion Surgery, Psychological Wellbeing