Evidence map›Paper›PMID 41555094›Full record

ArticleEuropean spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society2026

Impact of mental health disorders and perioperative outcomes following anterior cervical discectomy and fusion (ACDF): a national inpatient analysis.

Mitchell Ng, Leonidas Mastrokostas, Paul Mastrokostas, Gregorio Baek, Jonathan Dalton, Adam Fano, Alec Giakas, Rajendra Singh, Afshin Razi, Arya Varthi and 8 more

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Article in European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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0citing papers in PubMed
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1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

18 authors.

Mitchell NgRothman Orthopaedics, Philadelphia, USA. mitchng77@gmail.com.
Leonidas MastrokostasSUNY Downstate Medical Center, Brooklyn, USA.
Paul MastrokostasSUNY Downstate Medical Center, Brooklyn, USA.
Gregorio BaekRothman Orthopaedics, Philadelphia, USA.
Jonathan DaltonRothman Orthopaedics, Philadelphia, USA.
Adam FanoRothman Orthopaedics, Philadelphia, USA.
Alec GiakasRothman Orthopaedics, Philadelphia, USA.
Rajendra SinghSUNY Downstate Medical Center, Brooklyn, USA.
Afshin RaziMaimonides Medical Center, New York, USA.
Arya VarthiYale University, New Haven, USA.
Mark KurdRothman Orthopaedics, Philadelphia, USA.
Zachary WiltRothman Orthopaedics, Philadelphia, USA.
Daniel FassettAdventHealth Orlando, Orlando, USA.
Alan HilibrandRothman Orthopaedics, Philadelphia, USA.
Alexander VaccaroRothman Orthopaedics, Philadelphia, USA.
Gregory SchroederRothman Orthopaedics, Philadelphia, USA.
Christopher KeplerRothman Orthopaedics, Philadelphia, USA.
Andrew AlvarezAdventHealth Orlando, Orlando, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeMental health disorders have been shown to influence surgical outcomes, yet their effects on cervical spine surgery remain incompletely defined. This study evaluated the impact of depression and psychotic disorders on (1) perioperative complications, (2) discharge disposition, and (3) hospital resource utilization following anterior cervical discectomy and fusion (ACDF).

methodsThe National Inpatient Sample (NIS) was queried for adult ACDF admissions from 2016 to 2022. Patients were classified into those with either no mental illness, depression, or psychotic disorder. Medical/surgical complications, dysphagia, and overall adverse events were extracted using ICD-10 diagnosis codes. Discharge status, inpatient mortality, costs, and length of stay were also evaluated across all cohorts. Subsequent analyses were adjusted for demographics, Elixhauser comorbidity index, hospital characteristics, and levels fused. Fusion level was included as a categorical covariate (single-level vs. multilevel) in all adjusted regression models. Multivariable logistic regression estimated adjusted odds ratios for complications/discharge outcomes, while weighted linear models compared/contrasted healthcare utilization with statistical significance set at P < 0.05.

results376,130 inpatient ACDFs were identified (64,020 with depression, 11,255 with psychotic disorders). Depression was associated with increased cardiovascular complications (OR 1.28, 95% CI 1.16-1.41), dysphagia (OR 1.09, 95% CI 1.02-1.18), and non-routine discharge (OR 1.15, 95% CI 1.09-1.21). Psychotic disorders were associated with increased rates of cardiovascular events (OR 1.29, 95% CI 1.04-1.59), mechanical complications (OR 1.36, 95% CI 1.01-1.83), and non-routine discharge (OR 1.47, 95% CI 1.32-1.64). Both mean costs and length of stay were likewise higher in patients with mental disorders (P < 0.001).

conclusionMental health disorders are associated with increased postoperative complications, non-routine discharge, and healthcare utilization following ACDF. Appropriate diagnosis, management, and preoperative optimization may improve outcomes in this patient population.

Indexed as

Cervical VertebraeDiskectomyMental DisordersPostoperative ComplicationsSpinal FusionAdultAgedFemaleHumansInpatientsLength of StayMaleMiddle AgedTreatment OutcomeUnited StatesAnterior cervical discectomy and fusion (ACDF)DepressionHealthcare utilizationMental health disordersPerioperative complicationsPsychotic disorders

Identifiers

PMID41555094

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.