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Reasons and Results for Back Surgery

What do patients expect after back surgery? Do they get what they want? These are two questions asked by doctors at the Kimitsu Chuo Hospital in Japan.

Two groups of patients who had lumbar spine surgery were studied. Group one had the disc removed (discectomy) for lumbar disc herniation. Group two had a a piece of bone removed (laminotomy) for lumbar spinal stenosis.

Results of the operation were measured based on the intensity of low back pain, leg pain, and numbness. Walking ability and activity of daily living were also recorded. Patients were asked to list (in order of importance) their reasons for having the surgery. After the operation they were asked if they were better, same, or worse than expected.

The authors found that in general patients who expected greater success were happier with their results. Some patients said they didn't improve as much as hoped but they would have the same surgery again if they had to do it over.

They also found that patients with disc herniation had better results than the spinal stenosis group. Both groups had positive expectations. The authors aren't sure why the difference. They offer some ideas. Perhaps the surgeons led them to expect too much. Or maybe the patients expected more than the doctors said was possible. Finally, it's possible that the patients formed their own opinions regardless of what the doctors told them.

References: Tomoaki Toyone, MD, et al. Patients' Expectations and Satisfaction in Lumbar Spine Surgery. In Spine. December 1, 2005. Vol. 30. No. 3. pp. 2689-2694.

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