Correlation of patient satisfaction with symptom severity and walking ability after surgical treatment for degenerative lumbar spinal stenosis.
METHODS
Prospective follow-up of 83 patients who had decompressive laminotomy with or without fusion for degenerative lumbar spinal stenosis between September 1992 and September 1998.


OBJECTIVE
To evaluate the significance of the correlation between patient satisfaction and both the severity of postoperative symptoms and walking ability.


BACKGROUND
In clinical studies of surgery for degenerative lumbar spinal stenosis, patient satisfaction often is an item in the outcome questionnaire. However, little is known about the relationship of patient satisfaction to postoperative symptoms or functioning.


METHODS
Patients completed standardized preoperative and follow-up questionnaires about symptom severity, walking ability, and their satisfaction with the results of surgical treatment. The significance of the correlation of patient satisfaction with the severity of postoperative symptoms and walking ability was evaluated.


RESULTS
The mean length of follow-up was 39 months (range 12-84 months). The final questionnaire of a series was answered by 77 patients (93% of the cohort). By univariate analysis, the correlations of patient satisfaction with postoperative back pain, leg pain, numbness, subjective difficulty in walking, and walking ability were statistically significant (Spearman rank-order correlation coefficient: 0.58, 0.57, 0.53, 0.64, and 0.43, respectively). Postoperative walking ability was a weaker correlate of patient satisfaction than the severity of postoperative symptoms. By multivariate regression analysis, the only independent correlate was subjective difficulty in walking.


CONCLUSIONS
In the evaluation of patient satisfaction as an outcome in patients operated on for degenerative lumbar spinal stenosis, we should keep in mind that postoperative functioning is a weak correlate of satisfaction.
Department of Orthopaedic Surgery, Osaka National Hospital, Osaka, Japan. yamakazu@onh.go.jp
Kazuo
K
Yamashita
Junzo
J
Hayashi
Kenji
K
Ohzono
Kazuo
K
Hiroshima
D000368:Aged; D019299:Decompression, Surgical; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008159:Lumbar Vertebrae; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D011446:Prospective Studies; D013123:Spinal Fusion; D013130:Spinal Stenosis / Q000175:diagnosis / Q000601:surgery*; D016896:Treatment Outcome; D016138:Walking