A new study suggests that patient-satisfaction ratings after surgery for spinal degenerative disease—especially regarding reduced pain and disability—may be a good indicator of the surgery’s success, according to a news release from Wolters Kluwer Health.
The study appears in the August issue of Neurosurgery, the official journal of the Congress of Neurological Surgeons, published by Wolters Kluwer, per the release.
According to the release, the researchers analyzed 1-year follow-up data on 1,645 patients undergoing surgery for degenerative disease of the upper (cervical) and lower (lumbar) spine. Before and 1 year after surgery, the patients were evaluated using standard rating scales for disability and neck, back, arm, and leg pain.
Based on a spinal surgery satisfaction scale, 83% of patient said they were satisfied with the outcomes of surgery 1 year later, the release notes.
However, per the release, the researchers wanted to see whether any of the factors evaluated before surgery could predict whether patients would be satisfied or dissatisfied with their outcomes. After making adjustments for a wide array of patient-specific factors, they identified several specific predictors.
Patients who didn’t have at least a 15% improvement on a standard disability rating scale—considered to be the “minimal clinically important difference”—were four times more likely to be dissatisfied with their surgical outcomes.
Also, patients who didn’t achieve minimal clinically important differences in pain scores were about three times more likely to be dissatisfied with the results of surgery. Patients who were on Medicaid or uninsured also had lower satisfaction rates, as did those with higher initial pain and disability scores, the release continues.
Patients with depression or anxiety before surgery were less likely to achieve clinically meaningful improvement, and had lower satisfaction rates. However, after adjustment for initial pain and disability scores, these mental health factors were not significant predictors, according to the release.
The new study suggests that patient-satisfaction ratings after surgery for spinal degenerative disease line up well with the level of improvement in pain and disability achieved.
But the results also show a significant impact of initial pain and disability, suggesting that patients with more severe spinal degenerative disease are less likely to be satisfied with the results of surgery, the release continues.
Insurance status also seems to have an impact on patient-satisfaction rates, in that Medicaid recipients or uninsured patients may have lower satisfaction rates even if they do improve clinically, per the release.
The authors believe, per the release, that the study may provide tools to help identify individuals at risk of dissatisfaction and to improve the delivery of spine care, the authors believe.
“Individualizing the patient preoperative counseling on the basis of these patient-specific factors can improve patient satisfaction with outcomes,” the authors conclude in the release.
[Source(s): Wolters Kluwer Health, EurekAlert]