Evidence map›Paper›PMID 41569325›Full record

SynthesisNeurosurgical review2026

The effect of preoperative mental health on outcomes of cervical spine surgery: A systematic review and meta-analysis.

Sasha Howell, Yifei Sun, Hariteja Ramapuram, Nicholas M B Laskay, Jovanna Tracz, Anil Mahavadi, James Mooney, Lori L Davis, Carin Eubanks, Jakub Godzik

Abstract readSystematic ReviewMeta-Analysis
PubMed Publisher
In one paragraph

Synthesis in Neurosurgical review, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
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

10 authors.

Sasha HowellDepartment of Neurosurgery, University of Alabama at Birmingham, Birmingham, AL, 1030 Faculty Office Tower35233, USA.
Yifei SunMarnix E. Heersink School of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA.
Hariteja RamapuramMarnix E. Heersink School of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA.
Nicholas M B LaskayDepartment of Neurosurgery, University of Alabama at Birmingham, Birmingham, AL, 1030 Faculty Office Tower35233, USA.
Jovanna TraczDepartment of Neurosurgery, University of Alabama at Birmingham, Birmingham, AL, 1030 Faculty Office Tower35233, USA.
Anil MahavadiDepartment of Neurosurgery, University of Alabama at Birmingham, Birmingham, AL, 1030 Faculty Office Tower35233, USA.
James MooneyDepartment of Neurosurgery, Virginia Commonwealth University, Richmond, VA, USA.
Lori L DavisBirmingham Veterans Affairs Health Care System (BVAHCS), Birmingham, AL, USA.
Carin EubanksBirmingham Veterans Affairs Health Care System (BVAHCS), Birmingham, AL, USA.
Jakub GodzikDepartment of Neurosurgery, University of Alabama at Birmingham, Birmingham, AL, 1030 Faculty Office Tower35233, USA. jgodzik@uabmc.edu.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

BACKGROUND AND

objectiveMental health comorbidities have a significant impact on outcomes following cervical spine surgery. However, there is limited evidence clarifying the relationship between mental health and surgical outcomes. We sought to perform a systematic review and meta-analysis of the impact of mental health comorbidities on outcomes following cervical spine surgery.

methodsMedline, Embase, Scopus, and Web of Science were searched from inception to September 2024 for observational studies that investigated the association between preoperative mental health and outcomes following cervical spine surgery. Any mental health comorbidity, including but not limited to depression, anxiety, post-traumatic stress disorder (PTSD), bipolar, and others were included. The results were pooled using a restricted maximum-likelihood estimation random-effects model with inverse variance weighting. Cochrane’s Q was used to estimate heterogeneity between studies. Study quality was assessed via the Newcastle–Ottawa Scale (NOS).

resultsA total of 17 studies met inclusion criteria, totaling 259,915 patients [mean age: 56, 47.6% male). Of the studies, 10/17 (58.8%) reported on depression alone, while 7/17 (41.2%) reported a combination of mental health comorbidities. The majority of the studies (10/17) were of fair quality and did not influence study inclusion. After pooling patient functional, pain, disability, and quality of life scores, patients with preoperative mental health comorbidities had less improvement following cervical spine surgery (SMD -0.3345, 95%CI -0.6419 – 0.0272, p = 0.03, I2 = 95%). Additionally, patients with preoperative mental health comorbidities were also more likely to have complications following cervical spine surgery [OR 1.39, 95%CI 1.083 – 1.79, p = 0.01, I2 = 95%]. There was significant heterogeneity.

conclusionsPreoperative mental health comorbidities were associated with worse outcomes and increased rates of complications after cervical spine surgery. These findings highlight the influence of mental health on surgical recovery and suggest that addressing mental health preoperatively may improve patient outcomes. Future research is needed to validate these results in prospective cohorts and explore targeted interventions for preoperative optimization.

Indexed as

Cervical VertebraeMental DisordersMental HealthNeurosurgical ProceduresFemaleHumansMaleMiddle AgedTreatment OutcomeACDFCervical SpineComplicationsDegenerative Cervical MyelopathyMental HealthPatient Reported Outcomes

Identifiers

PMID41569325

What OpenQuestion holds

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Registered trials

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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.