title: The prognostic importance of patient pre-operative expectations of surgery for lumbar spinal stenosis.
abstract: The influence of psychosocial variables in the outcome of surgery for lumbar 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.
  
  
  CONCLUSIONS
  Patient expectations influence recovery from surgery at 6 months. To improve outcomes and satisfaction, clinicians should discuss expectations with patients pre-operatively.
authors.affiliation: Department of Physical Therapy, Bouve College of Pharmacy and Health Sciences, Northeastern University, Boston, MA 02115, USA.
authors.forename: M D
authors.initials: MD
authors.lastname: Iversen
authors.forename: L H
authors.initials: LH
authors.lastname: Daltroy
authors.forename: A H
authors.initials: AH
authors.lastname: Fossel
authors.forename: J N
authors.initials: JN
authors.lastname: Katz
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D001294:Attitude to Health; D005260:Female; D006801:Humans; D008297:Male; D010149:Postoperative Pain / Q000209:etiology; D017060:Patient Satisfaction; D011300:Preoperative Care / Q000523:psychology*; D011379:Prognosis; D013130:Spinal Stenosis / Q000523:psychology* / Q000601:surgery*; D011795:Surveys and Questionnaires; D016896:Treatment Outcome