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논문 기본 정보

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학술저널
저자정보
Lambrechts Mark James (Spine Service Rothman Orthopaedic Institute Thomas Jefferson University Philadelphia PA USA) D'Antonio Nicholas (Rothman Orthopaedic Institute at Thomas Jefferson University Hospital Philadelphia PA USA) Toci Gregory (Spine Service Rothman Orthopaedic Institute Thomas Jefferson University Philadelphia PA USA) Karamian Brian (Spine Service Rothman Orthopaedic Institute Thomas Jefferson University Philadelphia PA USA) Pezzulo Josuhu (Rothman Orthopaedic Institute at Thomas Jefferson University Hospital Philadelphia PA USA) Farronato Dominic (Rothman Orthopaedic Institute at Thomas Jefferson University Hospital Philadelphia PA USA) Canseco Jose (Spine Service Rothman Orthopaedic Institute Thomas Jefferson University Philadelphia PA USA) Kaye Ian David (Spine Service Rothman Orthopaedic Institute Thomas Jefferson University Philadelphia PA USA) Woods Barrett (Spine Service Rothman Orthopaedic Institute Thomas Jefferson University Philadelphia PA USA) Rihn Jeffrey (Spine Service Rothman Orthopaedic Institute Thomas Jefferson University Philadelphia PA USA) Kurd Mark (Spine Service Rothman Orthopaedic Institute Thomas Jefferson University Philadelphia PA USA) Lee Joseph (Rothman Orthopaedic Institute at Thomas Jefferson University Hospital Philadelphia PA USA) Hilibrand Alan (Spine Service Rothman Orthopaedic Institute Thomas Jefferson University Philadelphia PA USA) Kepler Christopher (Spine Service Rothman Orthopaedic Institute Thomas Jefferson University Philadelphia PA USA) Vaccaro Alexander Richard (Spine Service Rothman Orthopaedic Institute Thomas Jefferson University Philadelphia PA USA) Schroeder Gregory (Spine Service Rothman Orthopaedic Institute Thomas Jefferson University Philadelphia PA USA)
저널정보
대한척추외과학회 Asian Spine Journal Asian Spine Journal Vol.17 No.2
발행연도
2023.4
수록면
304 - 312 (9page)
DOI
10.31616/asj.2022.0065

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Study Design: Retrospective cohort.Purpose: To determine (1) the effects of serotonin reuptake inhibitors in pseudarthrosis rates after anterior cervical decompression and fusion (ACDF) and (2) to identify patient-reported outcome measures in patients taking serotonin reuptake inhibitors. Overview of Literature: Recent literature suggests that selective serotonin reuptake inhibitors (SSRIs) may inhibit fracture healing via downregulation of osteoblast differentiation. Spinal fusion supplementation with osteoblast-rich substances enhances spinal fusion, thus SSRIs may be detrimental.Methods: Patients with 1-year postoperative dynamic cervical spine radiographs following ACDF were grouped into serotonin reuptake inhibitor prescriptions (SSRI, serotonin-norepinephrine reuptake inhibitor [SNRI], or tricyclic antidepressant [TCA]) and no prescription (atypical antidepressant or no antidepressant). Pseudarthrosis was defined as ≥1 mm interspinous process motion on dynamic radiographs. Logistic regression models were controlled for confounding to analyze pseudarthrosis rates. Alpha was set at p - values of <0.05.Results: Of the 523 patients who meet the inclusion criteria, 137 (26.2%) were prescribed an SSRI, SNRI, or TCA. Patients with these prescriptions were more likely to have pseudarthrosis (p =0.008) but not a revision surgery due to pseudarthrosis (p =0.219). Additionally, these patients had worse 1-year postoperative mental component summary (MCS)-12 (p =0.015) and Neck Disability Index (NDI) (p =0.006). The multivariate logistic regression analysis identified SSRI/SNRI/TCA use (odds ratio [OR], 1.82; 95% confidence interval [CI], 1.11–2.99; p =0.018) and construct length (OR, 1.91; 95% CI, 1.50–2.44; p <0.001) as pseudarthrosis predictors. A SSRI/SNRI/TCA prescription was a revision surgery predictor due to adjacent segment disease on univariate analysis (OR, 2.51; p =0.035) but not on multivariate logistic regression analysis (OR, 2.24; p =0.10).Conclusions: Patients taking serotonin reuptake-inhibiting antidepressants are at increased risk of worse postoperative outcome scores, including NDI and MCS-12, likely due to their underlying depression. This may contribute to their greater likelihood of having adjacent segment surgery. Additionally, preoperative use of serotonin reuptake inhibitors in patients undergoing an ACDF is a predictor of radiographic pseudarthrosis but not pseudarthrosis revision.
#Cervical vertebrae #Diskectomy #Selective serotonin reuptake inhibitors #Depression #Pseudarthrosis

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