Many factors influence whether someone has a successful lower back surgery. Perhaps most importantly, your chosen orthopedic surgeon should have completed the fellowship training necessary to specialize in spine surgery. Patients should follow all preoperative directions. Patients should also know which medications to continue and which to defer until after the procedure. Patient should also follow all postoperative instructions and complete all physical therapy and rehabilitation requirements. However, new research has uncovered another important factors to help ensure a successful lower back surgery: Information.
Satisfaction and success
A team of Scandinavian orthopedic surgeons conducted a prospective study on 148 patients undergoing lumbar disc herniation surgery.1 They were interested in determining whether their patients were satisfied or dissatisfied with the surgical process. The surgeons also wanted to determine what could be done to improve herniated disc repair surgery, from start to finish. To do so, the patients included in this study were interviewed by physicians and given questionnaires before and two years after surgery.
The researchers found that greater than 80% of patients weresatisfied with the care they received before and after surgery—66% were satisfied and 28% were partly satisfied. Only 6% of patients interviewed said they were not satisfied with their surgical results.
Surprisingly, patient satisfaction did not correlate with objective success with the procedure. In other words, the outcome of the surgery had little impact on whether the patients were satisfied with their surgical experience. How could this be? The researchers found that satisfaction was tightly correlated with the amount of information patients received about the procedure and the surgical process. People who received adequate, high-quality information were more likely to be satisfied than those who felt they received inadequate information.
Why information is the key to success in lower back surgery
The researchers explained this surprising result by comparing patient satisfaction with patient expectations prior to surgery. People who had high expectations but did not meet those expectationswere understandably dissatisfied. For example, if patients believed they would be able to return to work, but were not able to do so after surgery, they were unhappy. Conversely, people who knew that they might not return to work after surgery were pleasantly surprised if they did and not disappointed if they could not.
While this may seem obvious, the key is having an open, honest, and realistic discussion with your spine surgeon before treatment. The researchers found that people who knew more about their procedure and their chances for recovery, were much more satisfied than patients who simply made assumptions.
Negative expectations are not good either
It is important to note that negative expectations were also associated with poor satisfaction. The researchers found that people with realistic expectations were satisfied with the process and procedure regardless of outcome. However, people who went into the procedure expecting the worst were quite likely to remain dissatisfied even if the outcome of the surgery was positive. Therefore, the best way to approach lower back surgery, it seems, is to learn as much about the procedure as possible and to be cautiously optimistic, rather than pessimistic.
Learning about lower back surgery
While the Internet is teeming with low quality and inaccurate medical information, your spine surgeon can help direct you to high-quality information that is freely available online. He may also have brochures and information packets to help you learn more about the process and your specific surgery. You will have at least one and likely several consultations with your spine surgeon before the day of surgery. This is an excellent time to have all of your questions answered to your satisfaction.
- Rönnberg K, Lind B, Zoëga B, Halldin K, Gellerstedt M, Brisby H. Patients’ satisfaction with provided care/information and expectations on clinical outcome after lumbar disc herniation surgery. Spine (Phila Pa 1976). 2007;32(2):256-261.