Details

Autor(en) / Beteiligte

• Cherry, Ahmed
• Canizares, Mayilee
• Rampersaud, Raja

Titel

Comparing patient preoperative expectations and postoperative expectation fulfillment between minimally invasive versus open fusion surgery

Ist Teil von

• Canadian Journal of Surgery, 2022-12, Vol.65, p.S132-S132

Ort / Verlag

Ottawa: CMA Impact, Inc

Erscheinungsjahr

2022

Quelle

EZB Electronic Journals Library

Beschreibungen/Notizen

• Background: Previous studies have highlighted the tion of expectations and fulfillment of expectations with patient-reported outcomes and satisfaction following spine surgery. We hypothesize that patients undergoing minimally invasive surgery (MIS) have higher preoperative expectations and are therefore less likely to attain postoperative expectation fulfillment. In this study, we aimed to compare preoperative expectations and postoperative fulfillment for patients undergoing MIS versus open posterior spinal fusions. Methods: We analyzed Canadian Spine Outcomes and Research Network (CSORN) registry data from 1308 patients (482 MIS and 826 open) who underwent 1- to 2-level fusion surgery between 2015 and 2019 with a primary degenerative spinal diagnosis. Preoperatively, patients reported their expectations as a result of the surgery (0 [no change], 1 [somewhat better], 2 [better] or 3 [much better]) for 7 items: leg pain, back pain, independence, sporting activities, general health, quality of social contacts and mental well-being. Patients also ranked their most important expectation. For each of these domains, patients reported whether the surgery fulfilled their expectations at 1 year follow-up. Results: Over 80% of patients reported expectations for improvements (at least somewhat better) in all items with the exception of sporting activities (71.3% v. 69.8%) and social encounters (64.3% v. 64.8%, MIS v. open), with no significant differences between groups. The most important expectation identified preoperatively was improvement in back pain (29.5% v. 31.0%, MIS v. open) in both groups. The calculated expectation score (0-100) was 75.9 versus 75.7 (overall score), 80.7 versus 80.4 (pain domains) and 71.1 versus 70.9 (general health domains) for the MIS versus open groups, respectively. At 1-year follow-up, there was a minor yet statistically significant difference in the proportion of patients reporting complete resolution of leg pain favoring the open group (37.6% v. 44.3%, p = 0.026) with no differences identified in any other fulfillment rankings. Conclusion: While variations in individual patient expectation and fulfillment exist, our data suggest that generally there are no significant differences in patient preoperative expectation or fulfillment between MIS and open fusion procedures. procedures.