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      Is depression the contraindication of anterior cervical decompression and fusion for cervical spondylosis?

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          Abstract

          Objective

          To evaluate whether depression is the contraindication of anterior cervical decompression and fusion (ACDF) for cervical spondylosis.

          Material and methods

          Patients with single-segment cervical spondylosis who underwent ACDF from January 2015 to December 2018 in our department were retrospectively included in this study and divided into two groups. Patients who were diagnosed of depression and prescribed with antidepressant drugs for at least 6 months before surgery were included in the intervention group. Patients without depression were included in the control group. The Beck Depression Inventory (BDI) score was used to evaluate the severity of depression. Visual Analogue Scale (VAS) score, Japanese Orthopeadic Association (JOA) score, Neck Disability Index (NDI), and the 36-Item Short-Form Health Survey (SF-36) were recorded as indexes to assess the pain, cervical spine function, degree of cervical spine injury, and life quality, respectively. The operative time, operative blood loss, hospital stay and complications were also recorded and compared.

          Results

          A total of 117 patients were included in this study, involving 32 patients in the intervention group and 85 patients in the control group. No significant differences were found in operative time, operative blood loss, hospital stay and complications between the two groups (P>0.05). The BDI score, VAS score, JOA score, NDI, SF-36 physical component score (SF-36 PCS) and SF-36 mental component score (SF-36 MCS) were all significantly improved at last follow-up in both the two groups. The intervention group showed higher BDI score and SF-36 MCS than the control group at both preoperative and the last follow-up (P<0.05), and the improvements of BDI score and SF-36 MCS were also higher in the intervention group (P<0.05). Although the intervention group showed higher VAS score, NDI, SF-36 PCS and lower JOA score at preoperative and last follow-up, respectively (P<0.05), there were no significant differences in the improvements of these indexes between the two group (P>0.05).

          Conclusions

          Depression is not the contraindication of ACDF for cervical spondylosis. Depression patients who received preoperative antidepressants can achieve similar improvement of clinical symptoms from ACDF with non-depression patients.

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          Most cited references33

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          Psychometric properties of the Beck Depression Inventory-II: a comprehensive review

          Objective: To review the psychometric properties of the Beck Depression Inventory-II (BDI-II) as a self-report measure of depression in a variety of settings and populations. Methods: Relevant studies of the BDI-II were retrieved through a search of electronic databases, a hand search, and contact with authors. Retained studies (k = 118) were allocated into three groups: non-clinical, psychiatric/institutionalized, and medical samples. Results: The internal consistency was described as around 0.9 and the retest reliability ranged from 0.73 to 0.96. The correlation between BDI-II and the Beck Depression Inventory (BDI-I) was high and substantial overlap with measures of depression and anxiety was reported. The criterion-based validity showed good sensitivity and specificity for detecting depression in comparison to the adopted gold standard. However, the cutoff score to screen for depression varied according to the type of sample. Factor analysis showed a robust dimension of general depression composed by two constructs: cognitive-affective and somatic-vegetative. Conclusions: The BDI-II is a relevant psychometric instrument, showing high reliability, capacity to discriminate between depressed and non-depressed subjects, and improved concurrent, content, and structural validity. Based on available psychometric evidence, the BDI-II can be viewed as a cost-effective questionnaire for measuring the severity of depression, with broad applicability for research and clinical practice worldwide.
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            STROCSS 2021: Strengthening the reporting of cohort, cross-sectional and case-control studies in surgery

            Strengthening The Reporting Of Cohort Studies in Surgery (STROCSS) guidelines were developed in 2017 in order to improve the reporting quality of observational studies in surgery and updated in 2019. In order to maintain relevance and continue upholding good reporting quality among observational studies in surgery, we aimed to update STROCSS 2019 guidelines.
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              Degenerative Cervical Spondylosis

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                Author and article information

                Contributors
                Journal
                Front Endocrinol (Lausanne)
                Front Endocrinol (Lausanne)
                Front. Endocrinol.
                Frontiers in Endocrinology
                Frontiers Media S.A.
                1664-2392
                30 September 2022
                2022
                : 13
                : 1031616
                Affiliations
                [1] 1 Department of Psychiatry, The First Branch, The First Affiliated Hospital of Chongqing Medical University , Chongqing, China
                [2] 2 Department of Psychiatry, The First Affiliated Hospital of Chongqing Medical University , Chongqing, China
                [3] 3 Department of Psychiatry, Chongqing Eleventh People’s Hospital , Chongqing, China
                [4] 4 Department of the First Clinical Medicine, Chongqing Medical University , Chongqing, China
                [5] 5 Department of Neurology, The Thirteenth People’s Hospital of Chongqing , Chongqing, China
                [6] 6 Department of Emergency, The Second Affiliated Hospital of Chongqing Medical University , Chongqing, China
                [7] 7 Department of Medical Oncology, The First Affiliated Hospital of Hainan Medical University , Haikou, China
                [8] 8 Department of Orthopedics, The First Affiliated Hospital of Chongqing Medical University , Chongqing, China
                Author notes

                Edited by: Baoshan Xu, Tianjin Hospital, China

                Reviewed by: Xiaozhong Zhou, Second Affiliated Hospital of Soochow University, China; Xueyu Hu, Fourth Military Medical University, China

                *Correspondence: Yinlian Pan, panyinlian@ 123456126.com ; Xing Du, duxing92@ 123456yeah.net

                †These authors have contributed equally to this work

                This article was submitted to Bone Research, a section of the journal Frontiers in Endocrinology

                Article
                10.3389/fendo.2022.1031616
                9561543
                36246923
                3ae6e549-174c-480c-a9ad-222a042a0e32
                Copyright © 2022 Chen, Li, Gan, Lu, Tian, Fu, Yang, Liu, Pan and Du

                This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

                History
                : 30 August 2022
                : 16 September 2022
                Page count
                Figures: 1, Tables: 3, Equations: 0, References: 33, Pages: 7, Words: 2857
                Categories
                Endocrinology
                Original Research

                Endocrinology & Diabetes
                depression,anterior cervical decompression and fusion,cervical spondylosis,clinical efficacy,safety

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