A study published in the Journal of Clinical Neuroscience examined the impact of pre-existing depression on outcomes for patients undergoing anterior cervical discectomy and fusion (ACDF) from 2020 to 2022. Out of 302 patients, 134 (44.4%) had a diagnosis of depression. The study found that patients with depression experienced significantly higher reoperation rates (18.7% vs. 4.8%) and reported greater persistent arm pain two years post-surgery. Additionally, their physical and mental health scores were notably lower at one year compared to non-depressed patients. The research highlights that preoperative depression is a strong predictor of poorer outcomes, including a fourfold increased risk of needing reoperation. Unlike previous studies, this analysis utilized multiple patient-reported outcomes (PROs) alongside clinical and radiographic data, reflecting a more comprehensive evaluation of depression’s effects, especially in the context of rising rates of depression post-COVID-19. The findings suggest that routine mental health screenings and tailored perioperative interventions could enhance recovery for these patients.