Surgeons’ Expectations More Accurate Than Patients’ Expectations in Predicting Patient-Reported Outcomes after Lumbar Spine Surgery

While patients may know their bodies better than medical professionals, when it comes to something as complicated as lumbar surgery, doctors tend to be far more accurate in their assessment of a patient’s recovery and capability after surgery. Patients tend to be more optimistic about what they will get from the surgery than professionals. Lower back pain is one of the primary reasons for lumbar spine surgery, but it is one of many different treatments, and one reason why medical professionals go over other options as well. They have a better idea of how people are likely to react to the surgery, including problems like mechanical issues resulting from the surgery. The professionals often suggest medication and minimally invasive treatments before recommending surgery. When these other methods don’t work, patients tend to think that surgery will provide the hoped for relief and significant improvements. This sets unrealistic expectations for many patients about what life will be like after the surgery.

To better understand the large gap in expectations and the outcome, several doctors established the HSS Lumbar Spine Surgery Expectations Survey, and sent it to several hundred patients in 2013. They looked at several factors in the survey including the following:

  • Relief expectations
  • Activity levels
  • Psychological health

Their survey has become a gold standard within the orthopedic sphere in understanding how patients feel about treatment. The study published in 2020 included 402 patients and their surgeons to see what the expectations were and how much those expectations diverged. The same group of 402 were again asked about the results two years later. Participating patients were on average 55 years old and had suffered chronic back pain for more than a year. They had different types of treatments and degrees of root causes for their pain. The average score for patients in their expectations was 73, indicating a very optimistic belief in how much their lives would improve. By comparison, surgeons scored an average of 57, indicating a much more realistic belief in how the surgery would change their patients’ lives. Surgeons were far more accurate in what the end results would be. Both groups were in agreement on what they expected to improve, just the degree of the improvement was different.

Ultimately, the study found that improvements need to be made in educating patients in what to expect. Patients are looking at the stories online or asking friends and acquaintances to see what to expect. Unfortunately, the stories of others really don’t apply because every case is different. While people can ask their surgeon about what to expect based on what they read, they should not be basing their expectations on the results others have had.

Check out Surgeons’ Expectations More Accurate Than Patients’ Expectations in Predicting Patient-Reported Outcomes after Lumbar Spine Surgery to learn more about setting more realistic expectations. You can also learn more about the Hospital for Special Surgery.

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