A group of spine surgeon researchers examined the Hospital for Special Surgery Cervical Spine Surgery Expectations Survey to see how patient expectations impact recovery and outcomes after cervical spine surgery. The findings were published in an issue of Spine.
The study included surveys from 150 patients and composed of 20 physical and psychological items. The average patient age was 54 years old and 61 percent of the patients were males. Here are five key findings from the study:
1. Nearly all — 97 percent of the patients — said they expected surgery to stop their spine condition from getting worse. Additional patient expectations included:
• Removing the control spine conditions had on their lives — 96 percent
• Relieving neck pain — 87 percent
• Relieving upper extremity pain — 85 percent
There were 23 percent of the patients who chose all items on the list as expectations post-surgery, and another 39 percent chose 16 to 18 items.
2. Patients were more likely to choose more items if they were younger, had worse NDI scores, worse SF-12 Physical and Mental Health Scores. "Multiple clinical variables were associated with expectations, with younger age and more disability due to pain being the most consistently associated with more expectations," the study authors concluded.
3. The average score out of 100 on the survey was 65±24. Patients were more likely to have higher scores if they were younger or had worse NDI scores. A 2002 study published in Spine found that patients often have unrealistic expectations of their surgery, which has a negative impact on their overall satisfaction with the procedure. In this study, 76.8 percent of the patients undergoing surgery for spinal stenosis were confident of achieving recovery. But, after the procedure, 30 percent were dissatisfied with their outcomes.
4. A 2005 study of 49 patients who underwent discectomy for lumber disc herniation and 49 who underwent laminotomy for lumbar spinal stenosis reported their expectations and outcomes for two years after surgery. More than half of the patients expected to have a 90 percent chance or greater of a completely successful surgery, but only 86 percent in the discectomy group and 71 percent in the laminotomy group reported that surgery met their expectations.
"Even if the clinical expectations were met, some patients were still dissatisfied," concluded the study authors in a Medscape report.
5. The surgeon expectations often differ from patient expectations as well. In a study published in Spine, authors noted a wide discrepancy between the patient and surgeon on expected outcomes and improvement in pain and function after surgery. The study authors called for "systematic, routine evaluation of outcomes" to help formulate realistic expectations of surgery.
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