A Measure of Patient Satisfaction after Back Surgery

Are patients happy with the results of degenerative spinal surgery in the back? Is their satisfaction based on symptoms or ability to walk after the operation? Doctors in Japan are following a group of 83 patients to find out. Doctors used to ask patients to rank the results after surgery by using a scale from poor to excellent. As medical costs continue to go up, more questions are being asked about the results of treatment. Patient satisfaction has become an important measure of health-care quality.

Degenerative spinal stenosis (DSS) refers to a narrowing of the spinal canal. The spinal canal surrounds the spinal cord. Degenerative means that the condition gets worse over time. DSS occurs as part of the aging process for many patients. Changes in the joints, ligaments, bones, or discs can cause DSS.

In this study all patients had surgery to remove a piece of vertebral bone, ligament, or joint. The purpose of the operation is to take pressure off the nerves inside the spinal canal in the low back. After the operation the doctors asked patients about back and leg pain and numbness or tingling in the legs. Symptoms were compared at rest and during walking. Walking time was also measured (how long the patient could walk without stopping).

The doctors also asked each patient, "How satisfied are you with the results of surgery?" The authors report that patients were affected most by how severe the pain was after the operation. The more pain relief they had, the happier they were with the results. Walking ability was important, but not as much as the intensity of pain.

Kazuo Yamashita, MD, et al. Correlation of Patient Satisfaction with Symptom Severity and Walking Ability after Surgical Treatment. In Spine. November 1, 2003. Vol. 28. No. 21. Pp. 2477-2481.

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