Mental health disorders do not seem to impact short-term perioperative recovery in adolescent idiopathic scoliosis patients undergoing posterior spinal fusion.

Abstract

This study investigates how MHD affects perioperative outcome metrics in adolescent idiopathic scoliosis (AIS) patients undergoing posterior spinal fusion (PSF). 525 AIS patients underwent PSF between 2018 and 2025. 78 patients were in Mental Health Disorder Group (MHD) and 447 were in no Mental Health Disorder group (nMHD) based on ICD-10 codes. MHD subtypes and prescribed psychotropic medications were categorized. Demographic, radiographic, surgical, and clinical data were collected. Maximum VAS Pain Scores and Morphine Consumption Data were analyzed (in Morphine Milligram Equivalence). Anxiolytic medications during hospital stay were recorded. SRS-22 questionnaire comparison was conducted. Wilcoxon rank-sum tests and Chi-square or Fisher's Exact tests were used. No difference in demographic and radiographic variables between groups (p > 0.05). EBL, transfusion, anesthesia, and operative time were not significant (p > 0.05). VAS max pain scores for POD0, POD1, and POD3 were similar, but higher on POD2 in MHD group (p = 0.015). No differences between groups in OOB, LOS, narcotic refills, and 90-day complications (p > 0.05). No significant differences in opioid requirements, but an increase in midazolam for MHD (p = 0.008). SRS-22 showed a significant decrease in Mental Health scores in the MHD group (p = 0.026), but no significance in pain, function, self-image, and satisfaction domains. Preexisting MHD disorders were not associated with worse short-term perioperative outcomes. Over the long term, SRS-22 scores indicate that both groups achieve similarly favorable outcomes in pain control, satisfaction, function, and self-image. Continued attention to MHD screening and long-term psychosocial follow-up remains essential, as MHD may be underdiagnosed in adolescents and could potentially exert more profound effects beyond the immediate recovery period. Future studies are needed to determine whether clinical outcomes in MHD patients go beyond the study's timeframe.