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Do Patient Expectations of Spinal Surgery Relate to Functional Outcome?

  • Original Article
  • Published:
Clinical Orthopaedics and Related Research

Abstract

It is important for surgeons to understand patients’ expectations for surgery. We asked whether patient factors and preoperative functional outcome scores reflect the degree of expectations patients have for posterior spinal surgery. Second, we asked whether patients’ expectations for surgery predict improvements in functional outcome scores after surgery. We prospectively enrolled 155 consecutive surgical patients with greater than 90% followup. Patients’ expectations were evaluated preoperatively along with SF-36 and Oswestry disability questionnaires. Postoperatively (6 months for decompression; 1 year for fusions), we quantified patient-derived satisfaction regarding whether expectations were met and by patient-derived functional outcome scores. In patients undergoing decompression, gender, SF-36 general health domain, and SF-36 physical component score predicted patients with high expectations for surgery. Patients with high expectations also reported greater postoperative improvements in SF-36 role physical domain scores after surgery. Expectations for surgery were met in 81% of patients. In a subset of patients (21 of 143), expectations were not met. These patients reported lower mean preoperative SF-36 general health, vitality, and mean mental component scores.

Level of Evidence: Level I, prognostic study. See the Guidelines for Authors for a complete description of levels of evidence.

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Acknowledgments

We appreciate the contributions of Christine Le, Emi Do, Dawn Barbieri, Dr. Mubarak Al-gahtany, and Lynn Antwi-Boasiako to this study, and we thank Dr. Marjan Vidmar for assistance with the statistical analysis.

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Authors and Affiliations

  1. The Spine Program, Division of Orthopaedic Surgery, Sunnybrook Health Sciences Centre, 2075 Bayview Avenue, Room MG 371-B, Toronto, ON, Canada, M4N 3M5

    Albert Yee MD, Nana Adjei BSc, Jennifer Do, Michael Ford MD & Joel Finkelstein MD

  2. Department of Surgery, University of Toronto, Toronto, ON, Canada

    Albert Yee MD, Michael Ford MD & Joel Finkelstein MD

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  1. Albert Yee MD
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  2. Nana Adjei BSc
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  3. Jennifer Do
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  4. Michael Ford MD
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  5. Joel Finkelstein MD
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Correspondence to Albert Yee MD.

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Each author certifies that he or she has no commercial associations (eg, consultancies, stock ownership, equity interest, patent/licensing arrangements, etc) that might pose a conflict of interest in connection with the submitted article.

Each author certifies that his or her institution has approved the protocol for this investigation and that all investigations were conducted in conformity with ethical principles of research.

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Yee, A., Adjei, N., Do, J. et al. Do Patient Expectations of Spinal Surgery Relate to Functional Outcome?. Clin Orthop Relat Res 466, 1154–1161 (2008). https://doi.org/10.1007/s11999-008-0194-7

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  • DOI: https://doi.org/10.1007/s11999-008-0194-7

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