The prognostic importance of patient pre-operative expectations of surgery for lumbar spinal stenosis

• Published in: Patient education and counseling 1998-06, Vol.34 (2), p.169-178
• Main Authors: Iversen, Maura D, Daltroy, Lawren H, Fossel, Anne H, Katz, Jeffrey N
• Format: Article
• Language: English
• Subjects: Activities of Daily Living; Aged; Attitude to Health; Doctor–patient communication; Expectation; Expectations; Female; Health outcomes; Humans; Male; Nursing; Outcomes of Treatment; Pain; Pain, Postoperative - etiology; Patient Satisfaction; Patients; Physical Mobility; Predictor Variables; Preoperative Care - psychology; Prognosis; Satisfaction; Spinal Stenosis - psychology; Spinal Stenosis - surgery; Surgery; Surveys and Questionnaires; Treatment Outcome
• ISSN: 0738-3991; 1873-5134
• DOI: 10.1016/S0738-3991(97)00109-2

The influence of psychosocial variables in the outcome of surgery for lumbar spinal stenosis (LSS) has not been evaluated. We studied 257 patients with LSS pre-operatively and at 6 months to: (a) relate patient expectations of surgery to baseline function and pain; and (b) determine how patient expectations and pre-operative function interact to predict post-operative outcomes. Results: On average, patients experienced substantial pain relief, improved function and satisfaction. Patients with many pre-operative expectations, particularly patients with low baseline function, reported more improvement in post-operative function than patients with few expectations. More ambitious expectations for physical function were also associated with improved function and satisfaction at 6 months. Conversely, having more numerous pain relief expectations was associated with more pain and less satisfaction with pain relief. Conclusion: Patient expectations influence recovery from surgery at 6 months. To improve outcomes and satisfaction, clinicians should discuss expectations with patients pre-operatively.