The prognostic importance of patient pre-operative expectations of surgery for lumbar spinal stenosis.
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.
Iversen
M D
MD
Department of Physical Therapy, Bouve College of Pharmacy and Health Sciences, Northeastern University, Boston, MA 02115, USA.
Daltroy
L H
LH
Fossel
A H
AH
Katz
J N
JN
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