O2099: The Impact of Mental Health on Post-operative Outcomes for Adolescents Undergoing Posterior Spinal Fusion for Idiopathic Scoliosis at a Tertiary Care Children’s Hospital in an Underserved Region

Background: Predictive factors such as mental health status and pain for postoperative outcomes have been demonstrated in the literature as key risk factors to medical treatment adherence, participation, rehabilitation, and surgical outcomes. Studies in adult patients have shown that pre-surgical depression and anxiety can lead to post-operative pain and new-onset mental illnesses.

Methods: We analyzed the records of 138 AIS-PSF patients (mean age 14.78±2.06, 67.4% female, 33.3% Hispanic, 39.9% Black), from 2012-2020. Preoperative and postoperative self-reported surveys (SRS-30, SRS-22) and Child Opportunity Index (COI) were analyzed using Pearson bivariate correlations. Survey responses were synthesized into composite scores for function, pain, self-image, and mental health.

Results: Bivariate analyses demonstrated associations at the 0.01-significance level between: pre-operative mental health and 6M post-operative mental health (r=0.3); 6M post-operative pain and 6M post-operative mental health (r=0.48); 6M post-operative self-image and 6M post-operative mental health (r=0.55). It was discovered that 73% of AIS-PSF patients have very Low social and economic COI score. Moreover, 28.3% of patients had worse mental health scores and 35.7% showed decline in pain score after 6 months post-operative, figure (1).

Conclusion: AIS-PSF patients with low pre-operative mental health scores were more likely to have worse mental health, self-image, and pain scores post-operatively. Furthermore, nearly one-third of patients reported worsened mental health following surgery. Our results support the growing literature on the interconnectedness of physical disease, mental health, and general well-being. These results validate the need for proper psychological evaluation and then targeted psychological intervention for at-risk individuals preoperatively as well as post-operatively to help improve their outcomes. This study has the potential to counterbalance several of the negative social determinants of health typically encountered by members of these vulnerable communities. This study has the potential to prevent delay recovery and longer hospital discharge.