TY - JOUR
T1 - Preoperative patient expectations and pain improvement after adult spinal deformity surgery
AU - Raad, Micheal
AU - Harris, Andrew B.
AU - Puvanesarajah, Varun
AU - El Dafrawy, Mostafa H.
AU - Kebaish, Floreana N.
AU - Neuman, Brian J.
AU - Skolasky, Richard L.
AU - Cohen, David B.
AU - Kebaish, Khaled M.
N1 - Publisher Copyright:
© AANS 2020, except where prohibited by US copyright law
PY - 2020/10
Y1 - 2020/10
N2 - OBJECTIVE Patients' expectations for pain relief are associated with patient-reported outcomes after treatment, although this has not been examined in patients with adult spinal deformity (ASD). The aim of this study was to identify associations between patients' preoperative expectations for pain relief after ASD surgery and patient-reported pain at the 2-year follow-up. METHODS The authors analyzed surgically treated ASD patients at a single institution who completed a survey question about expectations for back pain relief. Five ordinal answer choices to “I expect my back pain to improve” were used to categorize patients as having low or high expectations. Back pain was measured using the 10-point numeric rating scale (NRS) and Scoliosis Research Society-22r (SRS-22r) patient survey. Preoperative and postoperative pain were compared using analysis of covariance. RESULTS Of 140 ASD patients eligible for 2-year follow-up, 105 patients (77 women) had pre- and postoperative data on patient expectations, 85 of whom had high expectations. The mean patient age was 59 ± 12 years, and 46 patients (44%) had undergone previous spine surgery. The high-expectations and low-expectations groups had similar baseline demographic and clinical characteristics (p > 0.05), except for lower SRS-22r mental health scores in those with low expectations. After controlling for baseline characteristics and mental health, the mean postoperative NRS score was significantly better (lower) in the high-expectations group (3.5 ± 3.5) than in the low-expectations group (5.4 ± 3.7) (p = 0.049). The mean postoperative SRS-22r pain score was significantly better (higher) in the high-expectations group (3.3 ± 1.1) than in the low-expectations group (2.6 ± 0.94) (p = 0.019). CONCLUSIONS Despite similar baseline characteristics, patients with high preoperative expectations for back pain relief reported less pain 2 years after ASD surgery than patients with low preoperative expectations.
AB - OBJECTIVE Patients' expectations for pain relief are associated with patient-reported outcomes after treatment, although this has not been examined in patients with adult spinal deformity (ASD). The aim of this study was to identify associations between patients' preoperative expectations for pain relief after ASD surgery and patient-reported pain at the 2-year follow-up. METHODS The authors analyzed surgically treated ASD patients at a single institution who completed a survey question about expectations for back pain relief. Five ordinal answer choices to “I expect my back pain to improve” were used to categorize patients as having low or high expectations. Back pain was measured using the 10-point numeric rating scale (NRS) and Scoliosis Research Society-22r (SRS-22r) patient survey. Preoperative and postoperative pain were compared using analysis of covariance. RESULTS Of 140 ASD patients eligible for 2-year follow-up, 105 patients (77 women) had pre- and postoperative data on patient expectations, 85 of whom had high expectations. The mean patient age was 59 ± 12 years, and 46 patients (44%) had undergone previous spine surgery. The high-expectations and low-expectations groups had similar baseline demographic and clinical characteristics (p > 0.05), except for lower SRS-22r mental health scores in those with low expectations. After controlling for baseline characteristics and mental health, the mean postoperative NRS score was significantly better (lower) in the high-expectations group (3.5 ± 3.5) than in the low-expectations group (5.4 ± 3.7) (p = 0.049). The mean postoperative SRS-22r pain score was significantly better (higher) in the high-expectations group (3.3 ± 1.1) than in the low-expectations group (2.6 ± 0.94) (p = 0.019). CONCLUSIONS Despite similar baseline characteristics, patients with high preoperative expectations for back pain relief reported less pain 2 years after ASD surgery than patients with low preoperative expectations.
KW - Adult spinal deformity
KW - Back pain
KW - Health-related quality of life
KW - Patient expectations
KW - Patient-reported outcomes
KW - Scoliosis Research Society-22r patient survey
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U2 - 10.3171/2020.3.SPINE191311
DO - 10.3171/2020.3.SPINE191311
M3 - Article
C2 - 32534485
AN - SCOPUS:85092235330
SN - 1547-5654
VL - 33
SP - 496
EP - 501
JO - Journal of Neurosurgery: Spine
JF - Journal of Neurosurgery: Spine
IS - 4
ER -