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What comprises a good outcome in spinal surgery? A preliminary survey among spine surgeons of the SSE and European spine patients

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Abstract

Standardized and validated self-administered outcome-instruments are broadly used in spinal surgery. Despite a plethora of articles on outcome research, no systematic evaluation is available on what actually comprises a good outcome in spinal surgery from the patients’ and surgeons’ perspective, respectively. However, this is a prerequisite for improving outcome instruments. In performing a cross-sectional survey among spine patients from different European regions and spine surgeons of the SSE, the study attempted (1) to identify the most important domains determining a good outcome from a patients’ as well as a surgeon’s perspective, and (2) to explore regional differences in the identified domains. For this purpose, a structured interview was performed among 30 spine surgeons of the SSE and 353 spine surgery patients (representing Northern, Central and Southern Europe) to investigate their criteria for a good outcome. A qualitative and descriptive approach was used to evaluate the data. Results revealed a high agreement on what comprises a good outcome among surgeons and patients, respectively. The main parameters determining good outcome were achieving the patients’ expectations/satisfaction, pain relief, improvement of disability and social reintegration. Younger patients more often expected a complete pain relief, an improved work capacity, and better social life participation. Patients in southern Europe more often wanted to improve work capacity compared to those from central and northern European countries. No substantial differences were found when patients’ and surgeons’ perspective were compared. However, age and differences in national social security and health care system (“black flags”) have an impact on what is considered a good outcome in spinal surgery.

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References

  1. Beaton DE, Tarasuk V, Katz JN, Wright JG, Bombardier C (2001) “Are you better?” A qualitative study of the meaning of recovery. Arthritis Rheum 45:270–279

    Article  PubMed  CAS  Google Scholar 

  2. Billis EV, McCarthy CJ, Oldham JA (2007) Subclassification of low back pain: a cross-country comparison. Eur Spine J 16(7):865–879

    Article  PubMed  Google Scholar 

  3. Birkmeyer NJ, Weinstein JN (1999) Medical versus surgical treatment for low back pain: evidence and clinical practice. Eff Clin Pract 2:218–227

    PubMed  CAS  Google Scholar 

  4. Bombardier C (2000) Outcome assessments in the evaluation of treatment of spinal disorders: summary and general recommendations. Spine 25:3100–3103

    Article  PubMed  CAS  Google Scholar 

  5. Boos N (2006) Outcome assessment and documentation. Eur Spine J 15

  6. Boos N (2006) Outcome assessment and documentation: a friend or foe? Eur Spine J 15(Suppl 1):S1–S3

    Article  PubMed  Google Scholar 

  7. Breivik H, Collett B, Ventafridda V, Cohen R, Gallacher D (2006) Survey of chronic pain in Europe: prevalence, impact on daily life, and treatment. Eur J Pain 10:287–333

    Article  PubMed  Google Scholar 

  8. Buer N, Linton SJ (2002) Fear-avoidance beliefs and catastrophizing: occurrence and risk factor in back pain and ADL in the general population. Pain 99:485–491

    Article  PubMed  Google Scholar 

  9. Campbell C, Guy A (2007) Why can’t they do anything for a simple back problem?’: a qualitative examination of expectations for low back pain treatment and outcome. J Health Psychol 12:641–652

    Article  PubMed  Google Scholar 

  10. Costa LO, Maher CG, Latimer J (2007) Self-report outcome measures for low back pain: searching for international cross-cultural adaptations. Spine 32:1028–1037

    Article  PubMed  Google Scholar 

  11. Deyo RA, Battie M, Beurskens AJ, Bombardier C, Croft P, Koes B, Malmivaara A, Roland M, Von Korff M, Waddell G (1998) Outcome measures for low back pain research. A proposal for standardized use. Spine 23:2003–2013

    Article  PubMed  CAS  Google Scholar 

  12. Elfering A (2006) Work-related outcome assessment instruments. Eur Spine J 15(Suppl 1):S32–S433

    Article  PubMed  Google Scholar 

  13. Fritzell P, Hagg O, Wessberg P, Nordwall A (2001) 2001 Volvo award winner in clinical studies: Lumbar fusion versus nonsurgical treatment for chronic low back pain: a multicenter randomized controlled trial from the Swedish Lumbar Spine Study Group. Spine 26:2521–2532; discussion 2532–2524

    Article  PubMed  CAS  Google Scholar 

  14. Gepstein R, Arinzon Z, Adunsky A, Folman Y (2006) Decompression surgery for lumbar spinal stenosis in the elderly: preoperative expectations and postoperative satisfaction. Spinal Cord 44:427–431

    PubMed  CAS  Google Scholar 

  15. Grob D, Frauenfelder H, Mannion AF (2007) The association between cervical spine curvature and neck pain. Eur Spine J 16:669–678

    Article  PubMed  CAS  Google Scholar 

  16. Hagg O, Fritzell P, Oden A, Nordwall A (2002) Simplifying outcome measurement: evaluation of instruments for measuring outcome after fusion surgery for chronic low back pain. Spine 27:1213–1222

    Article  PubMed  Google Scholar 

  17. Kalso E (1996) Better standardisation will improve the quality of analgesic studies. Acta Anaesthesiol Scand 40:397–398

    PubMed  CAS  Google Scholar 

  18. Main CJ, Burton AK (2000) Economic and occupational influences on pain and disability. In: Main CJ, Spanswick CC (eds) Pain management: an interdisciplinary approach. Churchill Livingstone, Edinburgh, pp 63–87

    Google Scholar 

  19. Mannion AF, Elfering A, Staerkle R, Junge A, Grob D, Semmer NK, Jacobshagen N, Dvorak J, Boos N (2005) Outcome assessment in low back pain: how low can you go? Eur Spine J 14:1014–1026

    Article  PubMed  Google Scholar 

  20. McIntosh G, Hall H, Melles T (1998) The incidence of spinal surgery in Canada. Can J Surg 41:59–66

    PubMed  CAS  Google Scholar 

  21. Schmidt CO, Kohlmann T (2005) [What do we know about the symptoms of back pain? Epidemiological results on prevalence, incidence, progression and risk factors]. Z Orthop Ihre Grenzgeb 143:292–298

    Article  PubMed  CAS  Google Scholar 

  22. Toyone T, Tanaka T, Kato D, Kaneyama R, Otsuka M (2005) Patients’ expectations and satisfaction in lumbar spine surgery. Spine 30:2689–2694

    Article  PubMed  Google Scholar 

  23. Walsh K, Cruddas M, Coggon D (1992) Low back pain in eight areas of Britain. J Epidemiol Community Health 46:227–230

    Article  PubMed  CAS  Google Scholar 

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Conflict of interest

No benefits in any form have been or will be received from a commercial party. Study funded by a grant from the AOSpine, Grant number E-ORD 04/104.

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Correspondence to N. Boos.

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Haefeli, M., Elfering, A., Aebi, M. et al. What comprises a good outcome in spinal surgery? A preliminary survey among spine surgeons of the SSE and European spine patients. Eur Spine J 17, 104–116 (2008). https://doi.org/10.1007/s00586-007-0541-5

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  • DOI: https://doi.org/10.1007/s00586-007-0541-5

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