Key result
Thoracolumbar stabilization surgery is linked to ~70% patient satisfaction despite largely unfulfilled disability expectations.
Why the study?
Patient-reported outcome measures and patient satisfaction after thoracolumbar stabilization surgery require quantification and understanding of factors influencing satisfaction.
What are the patient-reported expectations, outcomes, and satisfaction levels in patients undergoing thoracolumbar stabilization surgery?
Observational (n=199)
No
What are the patient-reported expectations, outcomes, and satisfaction levels in patients undergoing thoracolumbar stabilization surgery?
Despite mostly unrealistic preoperative expectations, patients undergoing thoracolumbar stabilization surgery report high satisfaction and substantial improvements in pain and disability.
High satisfaction despite unmet expectations supports preoperative counseling; leaves open whether aligning expectations improves thoracolumbar stabilization outcomes.
Patient-reported outcome measures (PROMs) have become an important aspect of quality control in modern healthcare. In this prospective observational study on 199 patients undergoing thoracolumbar stabilization surgery, we quantified preoperative expectations and PROMs at six and twelve months after surgery, and we investigated what constitutes patient satisfaction with the outcome. We used the visual analogue scale (VAS) for pain and the Oswestry Disability Index (ODI). Preoperative expectations were high (expected ODI: 9 ± 13%; leg pain: 1.0 ± 1.4; back pain: 1.3 ± 1.5). Pain and disability improved substantially, but expectations were mostly unrealistic (ODI expectation fulfilled after six months: 28% of patients; back pain: 48%). However, satisfaction was high (70% at six months after surgery). Satisfied patients had significantly better pain and disability outcomes and higher rates of expectation fulfillment than non-satisfied patients. Patients undergoing revision stabilization had worse outcomes than all other diagnosis groups. Prior stabilization surgery was identified as an independent risk factor for dissatisfaction. There were no preoperative pain or disability levels that predicted dissatisfaction. The data presented in this study can provide benchmarks for diagnosis-specific PROM targets in thoracolumbar stabilization surgery. Future studies should investigate whether satisfaction can be influenced, e.g., by discussing realistic outcome targets with patients ahead of surgery.
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Krauß et al. (2020) conducted an observational in Thoracic and lumbar spine diseases requiring stabilization surgery (n=199). Thoracic and lumbar spine stabilization surgery was evaluated on Patient satisfaction at 6 months. Thoracic and lumbar spine stabilization surgery resulted in substantial improvements in pain and disability, yielding a 70% patient satisfaction rate at six months despite only 28% of patients having their disability expectations fulfilled.
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