Comparison of Patient Preference, Understanding, and Sentiment for Minimally Invasive Versus Open Spine Surgery

Abstract

Study Design. Retrospective questionnaire analysis.Objective. The goal of this study was to analyze patients' understanding and preferences for minimally invasive spine (MIS) versus open spine surgery. Summary of Background Data. MIS surgery is increasing in prevalence. However, there is insufficient literature to evaluate how the availability of MIS surgery influences the patients' decision-making process and perceptions of spine procedures. Methods. A survey was administered to patients who received a microdiscectomy or transforaminal lumbar interbody fusion between 2016 and 2020. All eligible patients were stratified into two cohorts based on the use of minimally invasive techniques. Each cohort was administered a survey that evaluated patient preferences, perceptions, and understanding of their surgery. Results. One hundred fifty two patients completed surveys (MIS: 88, Open: 64). There was no difference in time from surgery to survey (MIS: 2.1 AE 1.4 yrs, Open: 1.9 AE 1.4 yrs; P ¼ 0.36) or sex (MIS: 56.8% male, Open: 53.1% male; P ¼ 0.65). The MIS group was younger (MIS: 53.0 AE 16.9 yrs, Open: 58.2 AE 14.6 yrs; P ¼ 0.05). More MIS patients reported that their technique influenced their surgeon choice (MIS: 64.0%, Open: 37.5%; P < 0.00001) and increased their preoperative confidence (MIS: 77.9%, Open: 38.1%; P < 0.00001). There was a trend towards the MIS group being less informed about the intraoperative specifics of their technique (MIS: 35.2%, Open: 23.4%; P ¼ 0.12). More of the MIS cohort reported perceived advantages to their surgical technique (MIS: 98.8%, Open: 69.4%; P < 0.00001) and less reported disadvantages (MIS: 12.9%, Open: 68.8%; P < 0.00001). 98.9% and 87.1% of the MIS and open surgery cohorts reported a preference for MIS surgery in the future. Conclusion. Patients who received a MIS approach more frequently sought out their surgeons, were more confident in their procedure, and reported less perceived disadvantages following their surgery compared with the open surgery cohort. Both cohorts would prefer MIS surgery in the future. Overall, patients have positive perceptions of MIS surgery.

ROBOtic Care Outcomes Project for acute gallbladder pathology

“…32 Furthermore, patients exhibit a significant preference for minimally invasive surgical techniques. 33 Several other factors have been shown to increase the risk of conversion in our current study. Male patients, older than 45 years, and patients with sepsis or biliary obstruction all had twofold to threefold increased odds of conversion and obesity was associated 1.5-fold increased odds of conversion.…”

“…In this study, although the absolute risk reduction of 0.6% may not seem significant, more than a million minimally invasive cholecystectomies are performed annually in the United States, and thus the potential benefits translate to a large number of patients 32 . Furthermore, patients exhibit a significant preference for minimally invasive surgical techniques 33 …”

What Are Patients Saying About Minimally Invasive Spine Surgeons Online: A Sentiment Analysis of 2,235 Physician Review Website Reviews

“…Patients' perceptions of minimally invasive techniques further highlight perceived reductions in recovery time, complication rates, and cost as key advantages for MISS. At the same time, decreases in intraoperative visibility are seen as a potential disadvantage in MISS [4,5]. However, there was a notable discrepancy in comparing the aforementioned patient-perceived pros and cons of surgery with our sentiment analysis.…”

“…Despite this, patients have been shown to perceive decreased postoperative pain levels as a significant advantage of MISS. In a study by Narain et al, 84% of patients seeing a spine surgeon thought MISS would be less painful than open spine surgery [5]. This may result from literature suggesting that MISS results in less pain immediately following the surgery than open spine surgery, as is emphasized by reductions in narcotic use and length of stay [23][24][25].…”

“…A paucity of literature has analyzed patients' conceptions of MISS. However, in the limited available literature, it has been shown that patients generally have positive perceptions surrounding MISS techniques and perhaps a tendency to desire MISS compared to more traditional options (i.e., open surgery) [4][5][6]. These recent findings make it imperative that we further understand patients' perceptions of the surgeons who perform these procedures and what factors lead to a patient experience that is both satisfying and fulfilling.…”