Document Type

Article

Publication Date

7-24-2026

Comments

This article is the author's final published version in Journal of Craniovertebral Junction and Spine, Volume 17, Issue 4, July 2026, Pages 434-440.

The published version is available at https://doi.org/10.4103/jcvjs.jcvjs_95_26. Copyright © 2026 Journal of Craniovertebral Junction and Spine.

Abstract

CONTEXT: Psychiatric comorbidity has been associated with worse perioperative outcomes and greater healthcare utilization after spine surgery.

AIMS: This study compared complications and healthcare utilization among posterior cervical decompression and fusion (PCDF) patients with depression, psychotic disorders, or no mental-health diagnosis.

SETTINGS AND DESIGN: Retrospective cohort analysis of the National Inpatient Sample from 2016 to 2022.

MATERIALS AND METHODS: The database was queried for elective adult PCDF encounters. Mental-health exposures were defined using Elixhauser indicators for depression and psychoses. Outcomes included medical complications, non-routine discharge, inpatient mortality, length of stay (LOS), and costs.

STATISTICAL ANALYSIS USED: Chi-square and multivariate logistic regression analyses were performed. Significance was set at the

RESULTS: We identified 167,480 weighted admissions: 129,205 with no mental-health diagnosis, 32,500 with depression, and 5,775 with psychotic disorders. Depression was associated with higher odds of cardiovascular complications (odds ratio [OR]: 1.20,

CONCLUSIONS: Depression and psychotic disorders are common in PCDF and are linked to worse outcomes and higher resource use.

Creative Commons License

Creative Commons License
This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 4.0 License.

Language

English

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