A Comparison of Patient and Surgeon Preoperative Expectations of Spinal Surgery

Lattig, Friederike; Fekete, Tamás; O’Riordan, David; Kleinstück, Frank; Jeszenszky, Dezsö; Porchet, François; Mutter, Urs; Mannion, Anne F.

doi:10.1097/brs.0b013e318269c100

Cited by 50 publications

(40 citation statements)

References 15 publications

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“…8,13 Patient expectations have been studied for lumbar stenosis. 9,10,21 Lutz et al reported that patients with better expectations from their surgery had better outcomes after discectomy for disc herniation. 11 In contrast, McGregor and colleagues reported that patients undergoing spinal stenosis surgery frequently had unrealistically high expectations from their surgery and tended to have lower levels of satisfaction; 14,15 similarly, Toyone et al reported that patients with spinal stenosis tend to have more unrealistic and, consequently, unfulfilled expectations.…”

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confidence: 99%

Influence of depression symptoms on patient expectations and clinical outcomes in the surgical management of spinal stenosis

Urban-Baeza¹,

Zárate-Kalfópulos²,

Romero-Vargas³

et al. 2015

SPI

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OBJECT This prospective cohort study was designed to determine the influence of depressive symptoms on patient expectations and the clinical outcomes of the surgical management of lumbar spinal stenosis. METHODS Patients with an age > 45 years, a diagnosis of lumbar spinal stenosis at one level, and an indication for decompressive surgery were included in this study. Data for all of the following parameters were recorded: age, sex, highest level of education, and employment status. Depression symptoms (Beck Depression Inventory), disability (Oswestry Disability Index), and back and leg pain (visual analog scale) were assessed before surgery and at 12 months thereafter. The reasons for surgery and patient expectations (North American Spine Society lumbar spine questionnaire) were noted before surgery. The global effectiveness of surgery (Likert scale) was assessed at the 1-year follow-up. RESULTS Fifty-eight patients were divided into two groups based on the presence (Group 1) or absence (Group 2) of depressive symptoms preoperatively; each group comprised 29 patients. Demographic data were similar in both groups before surgery. The main reason to undergo surgery was “fear of a worse situation” in 34% of the patients in Group 1 and “to reduce pain” in 24% of the patients in Group 2. The most prevalent expectation was to improve my social life and my mental health in both groups. Surgery had a relieving effect on the depressive symptoms in 14 patients (48%). Thus, in the postoperative period, the number of patients who were free of depressive symptoms was 43 compared with the 15 who were depressed (p = 0.001). The 15 patients with persistent depression symptoms after surgery had a worse clinical outcome compared with the 43 patients free of depression symptoms at the 1-year follow-up in terms of severe back pain (20% vs 0%, respectively), severe leg pain (40% vs 2.3%, respectively), and severe disability (53% vs 9.3%, respectively). Only 33% of patients with persistent depression symptoms after surgery chose the option “surgery helped a lot” compared with 76% of patients without depression symptoms. Moreover, in terms of expectations regarding improvement in back pain, leg pain, walking capacity, independence, physical duties, and social activities, fewer patients were “completely satisfied” in the group with persistent depression symptoms after surgery. CONCLUSIONS Surgery for spinal stenosis had a relieving effect on preoperative depression symptoms at the 1-year follow-up. The persistence of depressive symptoms after surgery correlated with a worse clinical outcome and a higher rate of unmet expectations. Screening measures to detect and treat depression symptoms in the perioperative period could lead to better clinical results and increased patient satisfaction.

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confidence: 99%

Influence of depression symptoms on patient expectations and clinical outcomes in the surgical management of spinal stenosis

Urban-Baeza¹,

Zárate-Kalfópulos²,

Romero-Vargas³

et al. 2015

SPI

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“…The methodological characteristics of the articles found are similar, with 16 observational studies (9)(10)(13)(14)(18)(19)(20)(21)(22)24,26,(30)(31)(32)(33)(34) ; six prospective cohorts (25,(27)(28)34,(36)(37) ; one retrospective cohort (38) , one quasi-experimental study (35) , and one experimental study (29) . The use of instruments occurred in the immediate preoperative period in 21 studies that assessed patients' expectations (10,14,(18)(19)(20)(21)(22)(23)(24)(25)(26)(28)(29)(30)(31)(32)(33) , whereas in two studies it occurred when the patient received the indication of surgical treatment (9,27) , one study used them in the intermediate preoperative period (13) ; finally, one study completed the instrument after the patient underwent a spine surgery (34) . Three catego...…”

Section: Resultsmentioning

confidence: 75%

“…The studies were published between 1998 and 2015 and, in general, publications on this subject increased in the last five years (9)(10)14,(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30) . The methodological characteristics of the articles found are similar, with 16 observational studies (9)(10)(13)(14)(18)(19)(20)(21)(22)24,26,(30)(31)(32)(33)(34) ; six prospective cohorts (25,(27)(28)34,(36)(37) ; one retrospective cohort (38) , one quasi-experimental study (35) , and one experimental study (29) . The use of instruments occurred in the immediate preoperative period in 21 studies that assessed patients' expectations (10,14,(18)(19)(20)(21)(22)…”

Section: Resultsmentioning

confidence: 99%

“…In four of the 17 articles in this category, the researchers used the VAS as a way to measure expectation (21)(22)(23)36) , seven studies used a Likert scale (24,(26)(27)32,(34)(35)37) , and finally, in six studies the researchers created closed-ended questions addressing patients' expectations toward surgery (18,25,29,31,33,38) . Of these studies, in most cases, patients' expectation facing their main symptoms, such as pain, muscle function, and sensitivity (18, Instruments used in the assessment of expectation toward a spine surgery: an integrative review the general state of health, overall success of the surgery and recovery (23,29,31,33,35,36) ; two studies evaluated return to work (24,31) , and one assessed the social role (18) .…”

Section: Vilà-canet Et Almentioning

confidence: 99%

“…Of these studies, in most cases, patients' expectation facing their main symptoms, such as pain, muscle function, and sensitivity (18, Instruments used in the assessment of expectation toward a spine surgery: an integrative review the general state of health, overall success of the surgery and recovery (23,29,31,33,35,36) ; two studies evaluated return to work (24,31) , and one assessed the social role (18) . Only one study mentioned that the questions asked had already been used in another study, but to assess patient's satisfaction after receiving a conservative treatment (44) .…”

Section: Vilà-canet Et Almentioning

confidence: 99%

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Instruments used in the assessment of expectation toward a spine surgery: an integrative review

Nepomuceno

Silveira

Dessotte

et al. 2016

Rev. esc. enferm. USP

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Objective:To identify and describe the instruments used to assess patients' expectations toward spine surgery. Method: An integrative review was carried out in the databases PubMed, CINAHL, LILACS and PsycINFO. Results: A total of 4,402 publications were identified, of which 25 met the selection criteria. Of the studies selected, only three used tools that had confirmed validity and reliability to be applied; in five studies, clinical scores were used, and were modified for the assessment of patients' expectations, and in 17 studies the researchers developed scales without an adequate description of the method used for their development and validation. Conclusion: The assessment of patients' expectations has been methodologically conducted in different ways. Until the completion of this integrative review, only two valid and reliable instruments had been used in three of the selected studies. DESCRIPTORSPatients; Spinal Fusion; Spine; General Surgery; Review.Instruments used in the assessment of expectation toward a spine surgery: an integrative review Instrumentos utilizados na avaliação da expectativa diante do tratamento cirúrgico da coluna vertebral: revisão integrativa Instrumentos utilizados en la evaluación de la expectación ante el tratamiento quirúrgico de la columna vertebral: revisión integrativa

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How to Establish the Unilateral Biportal Endoscopic Surgery in the Surgeons’ Daily Practice

Suen

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2022

Unilateral Biportal Endoscopy of the Spine

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A Comparison of Patient and Surgeon Preoperative Expectations of Spinal Surgery

Cited by 50 publications

References 15 publications

Influence of depression symptoms on patient expectations and clinical outcomes in the surgical management of spinal stenosis

Influence of depression symptoms on patient expectations and clinical outcomes in the surgical management of spinal stenosis

Instruments used in the assessment of expectation toward a spine surgery: an integrative review

How to Establish the Unilateral Biportal Endoscopic Surgery in the Surgeons’ Daily Practice

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