Association between psychosocial factors and mental health symptoms to cervical spine pain with or without radiculopathy on health outcomes: systematic review protocol

Introduction:Cervical spine pain with or without radiculopathy (CSp R) has significant negative impacts to a person's quality of life. Psychosocial factors and/or mental health symptoms are associated with spinal pain with or without radiculopathy and negatively impact health outcomes. This area of research is not yet established for CSp R. Our objective is to conduct a systematic review assessing the association between psychosocial factors and/or mental health symptoms and health outcomes in adults with CSp +/- R.Methods:A systematic electronic search of 3 online databases will retrieve studies in which adults (older than 18 years) with CSp +/- R, assessing how psychosocial factors or mental health symptoms impact outcomes related to disability, pain, and/or healthcare utilisation. Data extracted will include study design, CSp +/- R definition, psychosocial and/or mental health symptoms, and health outcomes. Reporting study quality through the Newcastle-Ottawa Quality Scale Assessment and certainty through Grading of Recommendations, Assessment, Development and Evaluations will be completed. Studies will be assessed from a clinical perspective, methodology design, and statistical testing to determine whether studies can be pooled for meta-analysis. If there is significant clinical heterogeneity, narrative description will be undertaken.Perspective:This will be a comprehensive synthesis review to enhance understanding of the association of psychosocial factors and/or mental health symptoms and CSp +/- R on health outcomes. The findings will support the formulation of prognosis, collaborative management decisions, and guide healthcare resources to improve outcomes for this patient group. The review will identify gaps in research, thereby informing future experimental and observational study design.