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Patients’ expectations of lumbar spine surgery

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Abstract

Purpose

Patients undergoing lumbar spine surgery are a heterogeneous population and their expectations of surgery are likely to vary depending on individual and group characteristics. Our goal was to assess associations between expectations and demographic, psychological, and clinical characteristics in patients undergoing lumbar spine surgery.

Methods

Shortly before surgery (mean 7 ± 3 days) 420 patients completed the valid and reliable Hospital for Special Surgery, Lumbar Spine Surgery Expectations Survey, which encompasses physical and psychological expectations; scores range from 0 to 100, higher scores reflect greater expectations. Patients completed additional surveys addressing multiple variables, including disability due to pain with a modified version of the Oswestry Disability Index (ODI).

Results

The mean age was 55 ± 15 years, 57 % were men, and most surgery was for painful conditions. The mean Expectations Survey score was 72 ± 20 (range 2.5–100). In multivariate analysis, patients had higher scores (i.e., greater expectations) if they were younger (OR 1.02, CI 1.01, 1.04; p = .002), were not widowed (OR 4.9; CI 1.5, 15.5; p = .007), had prior chiropractic care (OR 1.8; CI 1.1, 2.8; p = .02), had worse ODI scores (OR 2.3; CI 1.5, 3.5; p = .0001), and had worse mental health scores (OR 1.8; CI 1.2, 2.8; p = .006). In additional multivariate analyses, worse ODI score was the clinical variable most closely associated with expecting more Expectations Survey items and expecting more improvement per item.

Conclusions

There were wide variations in expectations among patients. Multiple demographic, psychological, and clinical characteristics were associated with expectations, with disability due to pain being the most consistently associated variable.

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References

  1. Weinstein JN, Lurie JD, Olson PR, Bronner KK, Fisher ES (2006) United States’ trends and regional variations in lumbar spine surgery: 1992–2003. Spine 31:2707–2714

    PubMed Central  PubMed  Google Scholar 

  2. Mannion AF, Junge A, Elfering A, Dvorak J, Porchet F, Grob D (2009) Great expectations. Really the novel predictor of outcome after spinal surgery? Spine 34:1590–1599

    Article  PubMed  Google Scholar 

  3. Lattig F, Grob D, Kleinstueck FS, Porchet F, Jeszenszky D, Bartanusz V, O’Riordan D, Mannion AF (2009) Ratings of global outcome at the first post-operative assessment after spinal surgery: how often do the surgeon and patient agree? Eur Spine J 18(Suppl 3):S386–S394

    Article  Google Scholar 

  4. Becerra Fontal JA, Bago Granell J, Garre Olmo J, Roig Busquets R, Peris Prats F, Villanueva Leal C (2013) Evaluation of health-related quality of life in patients candidate for spine and other musculoskeletal surgery. Eur Spine J 22:1002–1009

    Article  PubMed Central  PubMed  Google Scholar 

  5. Stromqvist B, Fritzell P, Hagg O, Jonsson B, Sanden B (2013) Swespine: the Swedish spine register: the 2012 report. Eur Spine J 22(4):953–974

    Article  PubMed Central  PubMed  Google Scholar 

  6. Soroceanu A, Ching A, Abdu W, McGuire K (2012) Relationship between pre-operative expectations, satisfaction and functional outcomes in lumbar and cervical spine patients: a multi center study. Spine 37:E103–E108

    Article  PubMed  Google Scholar 

  7. Abbott AD, Tyni-Lenne R, Hedlund R (2011) Leg pain and psychological variables predict outcome 2–3 years after lumbar fusion surgery. Eur Spine J 20:1626–1634

    Article  PubMed Central  PubMed  Google Scholar 

  8. Saban KL, Penckofer SM (2007) Patient expectations of quality of life following lumbar spinal surgery. J Neurosci Nurs 39:180–189

    Article  PubMed  Google Scholar 

  9. Yee A, Adjei N, Do J, Ford M, Finkelstein J (2008) Do patient expectations of spinal surgery relate to functional outcome? Clin Orthop Relat Res 466:1154–1161

    Article  PubMed Central  PubMed  Google Scholar 

  10. Ronnberg K, Lind B, Zoega B, Halldin K, Gellerstedt M, Brisby H (2007) Patients’ satisfaction with provided care/information and expectations on clinical outcome after lumbar disc herniation surgery. Spine 32:256–261

    Article  PubMed  Google Scholar 

  11. Iversen MD, Daltroy LH, Fossel AH, Katz JN (1998) The prognostic importance of patient pre-operative expectations of surgery for lumbar spinal stenosis. Patient Educ Counsel 34:169–178

    Article  CAS  Google Scholar 

  12. Lutz GK, Butzlaff ME, Atlas SJ, Keller RB, Singer DE, Deyo RA (1999) The relation between expectations and outcomes in surgery for sciatica. J Gen Intern Med 14:740–744

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  13. Gepstein R, Arinzon Z, Adunsky A, Folman Y (2006) Decompression surgery for lumbar spinal stenosis in the elderly: preoperative expectations and posteroperative satisfaction. Spinal Cord 44:427–431

    CAS  PubMed  Google Scholar 

  14. Toyone T, Tanaka T, Kato D, Kaneyama R, Otsuka M (2005) Patients expectations and satisfaction in lumbar spine surgery. Spine 30:2689–2694

    Article  PubMed  Google Scholar 

  15. McGregor AH, Hughes SP (2002) The evaluation of the surgical management of nerve root compression in patients with low back pain: part 2: patient expectations and satisfaction. Spine 27:1471–1475

    Article  PubMed  Google Scholar 

  16. Mancuso CA, Sculco TP, Wickiewicz TL, Jones EC, Robbins L, Warren RF, Williams-Russo P (2001) Patients’ expectations of knee surgery. J Bone Joint Surg 83-A:1005–1012

  17. Mancuso CA, Sculco TP, Salvati EA (2003) Patients with poor preoperative functional status have high expectations of total hip arthroplasty. J Arthroplasty 18:872–878

  18. Mancuso CA, Altchek DW, Craig EV, Jones EC, Robbins L, Warren RF, Williams-Russo P (2002) Patients’ expectations of shoulder surgery. J Shoulder Elbow Surg 11:541–549

  19. Mancuso CA, Duculan R, Stal M, Girardi FP (2014) Patients’ expectations of cervical spine surgery. Spine (Phila Pa 1976) 39:1157–1162

  20. Mancuso CA, Cammisa FP, Sama AA, Hughes AP, Ghomrawi HMK, Girardi FP (2013)  Development and testing of an expectations survey for patients undergoing lumbar spine surgery. J Bone Joint Surg 95:1793–1800

  21. Hudson-Cook N, Tomes-Nicholson K, Breen A (1989) A revised Oswestry disability questionnaire. In: Roland M, Jenner JR (eds) Back pain: new approaches to rehabilitation and education. Manchester University Press, Manchester, pp 187–204

  22. Fairbank JCT, Mbaot JC, Davies JB, O’Brien JP (1980) The Oswestry low back pain disability questionnaire. Physiotherapy 66:271–273

    CAS  PubMed  Google Scholar 

  23. Yesavage JA, Brink TL, Rose TL, Lum O, Huang V, Adey M, Leirer VO (1983) Development and validation of a geriatric depression screening scale: preliminary report. J Psychiatr Res 17:37–49

    Article  CAS  Google Scholar 

  24. Spielberger CD (1983) State-Trait Anxiety Inventory for adults (form Y): manual, test, scoring key. Mind Garden Publisher, Redwood City

    Google Scholar 

  25. Ware JE Jr, Kosinski M, Keller SD (1996) A 12-item short-form health survey: construction of scales and preliminary tests of reliability and validity. Med Care 34:220–233

    Article  PubMed  Google Scholar 

  26. Mancuso CA, Jout J, Salvati EA, Sculco TP (2009) Fulfillment of patients’ expectations for total hip arthroplasty. J Bone Joint Surg Am 91:2073–2078

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Acknowledgments

The authors thank Frank P. Cammisa MD, Andrew A. Sama MD, Alexander P. Hughes MD, and Darren R. Lebl MD for their participation.

Conflict of interest

None.

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Authors and Affiliations

  1. Hospital for Special Surgery, 535 East 70th Street, New York, NY, 10021, USA

    Carol A. Mancuso, Roland Duculan, Marina Stal & Federico P. Girardi

  2. Weill Cornell Medical College, New York, NY, USA

    Carol A. Mancuso

Authors
  1. Carol A. Mancuso
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  2. Roland Duculan
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  3. Marina Stal
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  4. Federico P. Girardi
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Corresponding author

Correspondence to Carol A. Mancuso.

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Mancuso, C.A., Duculan, R., Stal, M. et al. Patients’ expectations of lumbar spine surgery. Eur Spine J 24, 2362–2369 (2015). https://doi.org/10.1007/s00586-014-3597-z

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  • DOI: https://doi.org/10.1007/s00586-014-3597-z

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