Patient Expectations and Outcomes in Spine Surgery
Summary
Spine surgery presents a complex interplay between clinical objectives and the personal goals that patients bring to the operating theatre. Preoperative expectations span pain relief, restoration of function and return to daily activities, yet these aspirations often exceed achievable outcomes. Patient-reported outcome measures (PROMs) have been adopted to capture subjective perceptions of pain, disability and overall satisfaction. Common findings reveal that although pain and functional scores improve substantially after decompression, fusion or stabilisation procedures, patients frequently rate their postoperative status as less favourable than anticipated. Despite this, satisfaction remains high in many cohorts, suggesting that fulfilment of expectations constitutes only one facet of perceived success. Factors shaping expectation–outcome discrepancies include age, education level, previous surgical history and mental health status. Effective physician–patient communication and shared decision-making can align understanding of realistic goals, mitigate dissatisfaction and foster better long-term engagement with rehabilitation. Globally, refinements in preoperative counselling and standardisation of outcome assessment lay the groundwork for personalised care pathways and improved resource allocation in spine services.
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Patient Expectations and Outcomes in Spine Surgery publication trend
The graph below shows the total number of articles in patient expectations and outcomes in spine surgery across all publications each year (not limited to Nature Index journals).
Technical terms
Visual analogue scale (VAS): A continuous line, typically 100 mm in length, on which patients mark their perceived level of pain or symptom intensity.
Oswestry Disability Index (ODI): A patient-completed questionnaire assessing degree of disability and functional impairment related to lower back pain.
Patient-reported outcome measure (PROM): A standardised instrument for evaluating health status directly from the patient, without interpretation by clinicians or others.
Patient’s experience of care (PEC) index: A composite questionnaire designed to capture multiple dimensions of perioperative care quality from the patient’s perspective following spinal surgery.
References
- Patients’ experience of care index: A new, reliable, and useful questionnaire in lumbar spine surgery. Brain and Spine (2024).
- Patient-Reported Expectations, Outcome and Satisfaction in Thoracic and Lumbar Spine Stabilization Surgery: A Prospective Study. Surgeries (2020).
- Evaluation of Patient Expectations for Surgical Treatment of Degenerative Disease of the Lumbosacral Spine. Russian Journal of Spine Surgery (Khirurgiya Pozvonochnika) (2023).
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