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Patients, Spinal Surgeons Differ in Expectations of Sx Outcomes

Expectations higher for patients than surgeons, especially for back or neck pain and function

Patients, Spinal Surgeons Differ in Expectations of Sx Outcomes

TUESDAY, July 2 (HealthDay News) -- For patients and spinal surgeons, there are frequently wide discrepancies in the expectations of the outcomes of surgery, according to a study published in the May 20 issue of Spine.

Friederike Lattig, M.D., from the Schulthess Klinik in Zurich, and colleagues evaluated the level of agreement in preoperative expectations for 225 German-speaking patients (mean age, 62 years) and their seven spinal surgeons. Patients and surgeons completed a questionnaire about baseline neurologic status and realistic expectations regarding patient-oriented outcomes (axial pain [back/neck]; radiating pain [leg/arm]; pain medication usage; sensory and motor function; and the ability to work, perform household activities, and play sports) following a preoperative informed consent consultation.

The researchers found that patients and surgeons agreed about the existence of spine-related neurological deficits in 75 percent (sensory) and 61 percent (motor) of cases. In 20 and 35 percent of cases, the patient, but not the surgeon, reported a sensory deficit and motor deficit, respectively, whereas in 4 to 5 percent of cases, the patient was seemingly unaware of a physician-reported deficit. Expectations were consistently higher for patients than surgeons, especially for back or neck pain and function (work, household activity, and sports), with weighted κ values for agreement ranging from 0.097 to 0.222.

"The findings demonstrate wide discrepancies between the patient and the surgeon regarding the expected result of surgery," the authors write. "They highlight the need for clearer explanations of the association between the spinal problem and neurological deficits and the improvement that can be expected in pain and function after surgery."

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