Patient mind-set indicator of spine surgery success

spine surgery

A number of non-surgical factors could be influencing patients’ satisfaction levels following spinal surgery, a US study suggests. 

Everything from how the patient paid for their spinal degenerative disease surgery to their psychological profile contributed to their satisfaction level, says Dr. Clinton J. Devin of Vanderbilt University Medical Center, Nashville.


Measure surgery outcomes

The research team looked at 1,645 patients who had undergone surgery for degenerative disease of the upper and lower spine. 

They measured the patients’ disability levels along with neck, back, arm and leg pain before and a year after surgery.  

The surveys found 83% were satisfied with the outcomes of the surgery after a year. 

The researchers then investigated whether any other factors measured before surgery could accurately predict patient satisfaction levels post-surgery.


A number of predictors were found: 

  • Surgical effectiveness: There was a strong connection betweendissatisfaction levels and an individual patient’s ability to achieve clinical improvements for their disability
  • Initial pain: Those with higher levels of pain or disability were less likely to be satisfied with the surgery, regardless of the surgery’s success
  • Insurance: Uninsuredpatients had lower satisfaction rates even if they did improve clinically
  • Psychological profile: Patients who suffered from depression, anxiety or drug use were less likely to achieve clinically meaningful improvement – again, despite the surgery’s success


Dr. Devin says that as patient satisfaction scores are often used in America to determine levels of reimbursement for care provided, identifying any factors that can improve satisfaction is hugely important.


Target patients before surgery

It is hoped the research can be used to target patients who could be at risk of dissatisfaction and to improve how their care is delivered. 

Dr Devin says providing patients with individualised preoperative counselling based on these various factors could help improve satisfaction levels. 

For example, giving patients a more realistic view of their chances of clinical improvements could boost their satisfaction levels after the surgery. 

But the team did admit more research is needed into how important insurance status and initial severity scores were on the outcomes.


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