The impact of pathoanatomical diagnosis on elective spine surgery patient expectations: A Canadian spine outcomes and research network study

R. Andrew Glennie, Mayilee Canizares, Anthony V. Perruccio, Edward Abraham, Fred Nicholls, Andrew Nataraj, Philippe Phan, Najmedden Attabib, Michael G. Johnson, Eden Richardson, Greg McIntosh, Henry Ahn, Charles G. Fisher, Neil Manson, Kenneth Thomas, Y. Raja Rampersaud

Research output: Contribution to journalArticlepeer-review

4 Citations (Scopus)

Abstract

Objective: Patients undergoing spine surgery generally have high expectations for improvement postoperatively. Little is known about how these expectations are affected by the diagnosis. The purpose of this study was to examine whether preoperative expectations differ based on diagnostic pathoanatomical patterns in elective spine surgery patients. Methods Patients with common degenerative cervical/lumbar pathology (lumbar/cervical stenosis, lumbar spondylolisthesis, and cervical/lumbar disc herniation) who had given their consent for surgery were analyzed using the Canadian Spine Outcomes and Research Network (CSORN). Patients reported the changes they expected to experience postoperatively in relation to 7 separate items using a modified version of the North American Spine Society spine questionnaire. Patients were also asked about the most important item that would make them consider the surgery a success. Sociodemographic, lifestyle, and clinical variables were also collected. Results: There were 3868 eligible patients identified within the network for analysis. Patients with lumbar disc herniation had higher expectations for relief of leg pain compared with stenosis and lumbar degenerative spondylolisthesis cohorts within the univariate analysis. Cervical stenosis (myelopathy) patients were more likely to rank general physical capacity as their most important expectation from spine surgery. The multinomial regression analysis showed that cervical myelopathy patients have lower expectations for relief of arm or neck pain from surgery (OR 0.54, 0.34-0.88; p < 0.05). Patient factors, including age, symptoms (pain, disability, depression), work status, and lifestyle factors, were significantly associated with expectation, whereas the diagnoses were not. Conclusions: Patients with degenerative spinal conditions consenting for spine surgery have high expectations for improvement in all realms of their daily lives. With the exception of patients with cervical myelopathy, patient symptoms rather than diagnoses had a more substantial impact on the dimensions in which patients expected to improve or their most important expected change. Determination of patient expectation should be individualized and not biased by pathoanatomical diagnosis.

Original languageEnglish
Pages (from-to)34-41
Number of pages8
JournalJournal of Neurosurgery: Spine
Volume35
Issue number1
DOIs
Publication statusPublished - Jul 2021

Bibliographical note

Funding Information:
Dr. Glennie: support of non-study-related clinical or research effort from Medtronic. Dr. Nicholls: honoraria from DePuy Synthes. Dr. Johnson: clinical or research support for the study described from Stryker. Dr. Fisher: consultant for Medtronic and NuVasive; royalties from Medtronic; and fellowship support paid to institution from Medtronic and AO Spine. Dr. Manson: consultant for and support of non-study-related clinical or research effort from Medtronic Canada. Dr. Rampersaud: royalties from Medtronic.

Publisher Copyright:
© 2021 AANS.

ASJC Scopus Subject Areas

  • Surgery
  • Neurology
  • Clinical Neurology

PubMed: MeSH publication types

  • Journal Article

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