Patients are more optimistic about their surgical outcomes than surgeons, and that gap could create issues in the future.
A study, "Concordance between Patients' and Surgeons' Expectations of Lumbar Spine Surgery," presented at the NASS Annual Meeting reports 87 percent of lumbar spine surgery patients have more optimistic expectations for surgical outcomes than their surgeons; on the contrary, only 11 percent had lower expectations than surgeons.
"While it may seem obvious that experienced surgeons would have a more realistic view of surgical outcomes than patients, this wide expectation gab is disturbing," says Gwendolyn Sowa, MD, PhD, a physiatrist and NASS Annual Meeting Program Chair. "Before a surgery date is even scheduled, it is essential that the surgeon and patient have clear conversations about their expectations for the surgery, including recovery time, after care and anticipated outcomes so that they can work toward the same goals."
Here are five key notes:
1. Patients often undergo surgery for improved physical and psychological symptoms and unrealistic expectations can hurt the ultimate outcome. Additionally, patients with low expectations may be predisposed to poor outcomes if they don't make certain lifestyle changes.
2. The findings show discussing expectations before surgery can address the amount of improvement and how patients can maximize the potential for positive outcomes.
3. The researchers are developing a curriculum for patients to address realistic expectations for surgery. The curriculum is based on surgeons' ratings regarding appropriate expectations for most patients according to the diagnosis and preoperative status.
4. There were several study authors from Hospital for Special Surgery in New York City, including:
• Carol A. Mancuso, MD
• Roland Duculan, MD
• Frank Cammisa Jr., MD
• Andrew A. Sama, MD
• Alexander P. Hughes, MD
• Darren R. Lebl, MD
• Federico P. Girardi, MD