Researchers studied the fulfillment of patient expectations following lumbar and cervical spine surgery, according to a study published in The Spine Journal. Of the patients studied, 366 underwent lumbar surgery and 133 received cervical surgery.
The study utilized self-reported valid surveys, the Oswestry Disability Index and Neck Disability Index. The survey involved 20 questions, asking for patients' expectations about symptom improvement, physical function and mental well-being.
Two years later, patients reported the fulfillment of each of their expectations. The researchers calculated a proportion of each patient's actual amount of improvement versus the amount of improvement they anticipated. The proportion ranged from zero (no fulfilled expectations) to one (fulfilled expectations) to greater than one (surpassed expectations).
Here are seven takeaways:
1. Of the 366 lumbar surgery patients, 90 percent reported at least some fulfilled expectations, with the mean proportion of fulfilled expectations at 0.66.
• Surpassed expectations — 15 percent
• Fulfilled expectations — 9 percent
• Somewhat fulfilled expectations — 66 percent
2. Ten percent of lumbar surgery patients reported no fulfilled expectations.
3. The researchers discovered several factors correlating with fewer fulfilled expectations among lumbar surgery patients including, "preoperative expectations, not working full-time, previous spine surgery, surgery for more vertebral levels, subsequent spine surgery and less improvement in pre- to postoperative ODI and pain scores," according to the study.
4. Of the 133 cervical surgery patients, 91 percent reported at least some fulfilled expectations, with the mean proportion of fulfilled expectations at 0.78.
• Surpassed expectations — 23 percent
• Fulfilled expectations — 8 percent
• Somewhat fulfilled expectations — 60 percent
5. Nine percent of cervical surgery patients reported no fulfilled expectations.
6. The study noted some variables associated with fewer fulfilled expectations among cervical surgery patients including, "more preoperative expectations and less improvement in pre-to postoperative NDI and pain scores," according to the study.
7. The researchers concluded patient expectations following spine surgery correlated with "multiple pre-and postoperative variables, including the amount of improvement expected preoperatively," according to the study.