The Relation of Patient Expectations, Satisfaction, and Outcome in Surgery of the Cervical Spine

TY - JOUR

T1 - The Relation of Patient Expectations, Satisfaction, and Outcome in Surgery of the Cervical Spine

T2 - A Prospective Study

AU - Krauss, Philipp

AU - Reinartz, Feline

AU - Sonnleitner, Clara

AU - Vazan, Martin

AU - Ringel, Florian

AU - Meyer, Bernhard

AU - Meyer, Hanno S

N1 - Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.

PY - 2022/6/15

Y1 - 2022/6/15

N2 - STUDY DESIGN: We performed a prospective nonblinded single center observational study.OBJECTIVE: To investigate the relationship between expectations, outcome, and satisfaction with the outcome in patients undergoing cervical spine stabilization surgery.SUMMARY OF BACKGROUND DATA: In modern healthcare, patient-reported outcome measures and patient satisfaction have become an important aspect of quality control. Therefore, outcome benchmarks for specific diseases are highly desired. Numerous studies have investigated patient-reported outcome measures and what constitutes satisfaction in degenerative lumbar spine disease. In cervical spine surgery, it is less clear what drives the postoperative symptom burden and patient satisfaction and how this depends on the primary diagnosis and other patient factors.METHODS: This was a prospective, single center, observational study on patients undergoing cervical spine stabilization surgery for degenerative disease, trauma, infection, or tumor. Using the visual analogue scale for neck and arm pain, the neck disability index (NDI), the modified Japanese Orthopedic Association Score (mJOA) and patient-reported satisfaction, patient status and expectations before surgery, at discharge, 6 and 12 months after surgery were evaluated.RESULTS: One hundred five patients were included. Score-based outcome correlated well with satisfaction at 6 and 12 months. Except for low NDI expectations (≥15 points) that correlated with dissatisfaction, expectations in no other score were correlated with satisfaction. Expectations did influence the outcome in some subgroups and meeting expectations resulted in higher rates of satisfaction. Pain reduction plays an important role for satisfaction, independently from the predominant symptom or pathology.CONCLUSION: Satisfaction correlates well with outcome. Meeting expectations did influence satisfaction with the outcome. The NDI seems to be a valuable preoperative screening tool for poor satisfaction at 12 months. In degenerative pathology, pain is the predominant variable influencing satisfaction independently from the predominant symptom (including myelopathy).LEVEL OF EVIDENCE: 5.

AB - STUDY DESIGN: We performed a prospective nonblinded single center observational study.OBJECTIVE: To investigate the relationship between expectations, outcome, and satisfaction with the outcome in patients undergoing cervical spine stabilization surgery.SUMMARY OF BACKGROUND DATA: In modern healthcare, patient-reported outcome measures and patient satisfaction have become an important aspect of quality control. Therefore, outcome benchmarks for specific diseases are highly desired. Numerous studies have investigated patient-reported outcome measures and what constitutes satisfaction in degenerative lumbar spine disease. In cervical spine surgery, it is less clear what drives the postoperative symptom burden and patient satisfaction and how this depends on the primary diagnosis and other patient factors.METHODS: This was a prospective, single center, observational study on patients undergoing cervical spine stabilization surgery for degenerative disease, trauma, infection, or tumor. Using the visual analogue scale for neck and arm pain, the neck disability index (NDI), the modified Japanese Orthopedic Association Score (mJOA) and patient-reported satisfaction, patient status and expectations before surgery, at discharge, 6 and 12 months after surgery were evaluated.RESULTS: One hundred five patients were included. Score-based outcome correlated well with satisfaction at 6 and 12 months. Except for low NDI expectations (≥15 points) that correlated with dissatisfaction, expectations in no other score were correlated with satisfaction. Expectations did influence the outcome in some subgroups and meeting expectations resulted in higher rates of satisfaction. Pain reduction plays an important role for satisfaction, independently from the predominant symptom or pathology.CONCLUSION: Satisfaction correlates well with outcome. Meeting expectations did influence satisfaction with the outcome. The NDI seems to be a valuable preoperative screening tool for poor satisfaction at 12 months. In degenerative pathology, pain is the predominant variable influencing satisfaction independently from the predominant symptom (including myelopathy).LEVEL OF EVIDENCE: 5.

KW - Cervical Vertebrae/surgery

KW - Humans

KW - Motivation

KW - Pain

KW - Patient Satisfaction

KW - Personal Satisfaction

KW - Prospective Studies

KW - Treatment Outcome

U2 - 10.1097/BRS.0000000000004351

DO - 10.1097/BRS.0000000000004351

M3 - SCORING: Journal article

C2 - 35752895

VL - 47

SP - 849

EP - 858

JO - SPINE

JF - SPINE

SN - 0362-2436

IS - 12

ER -