The patient’s perspective on complications after spine surgery

Abstract

Recent years have witnessed a paradigm shift in relation to the assessment of outcome in spine surgery: multidimensional patient-centred questionnaires have superseded traditional surgeon-based ratings of outcome, and surgical registries have been developed to capitalise on the principle of ''strength in numbers.'' However, the assessment of complications has not enjoyed this same enlightened patient-centred approach. The present study investigated post-surgical complications from the patient's perspective. All German-speaking patients undergoing surgery within our Spine Center in 2005 were asked to complete the patient-orientated Core Measures Outcome Index of the SSE Spine Tango Spine Surgery Registry before and 12 months after surgery; the surgeon completed a Spine Tango surgery form. In the 12-month questionnaire, the patient was asked, ''did any complications arise as a consequence of your operation 1 year ago (e.g. problems with wound healing, paralysis, sensory disturbances, etc.)? If so, give details.'' Patients were also asked about their satisfaction with the operation and the global outcome of surgery. 1,035 patients were sent a 12-month questionnaire; 972 (94%) returned the completed questionnaire. 29% patients answered ''yes'' to the question about complications. The incidence of patient-rated complications was significantly associated with outcome/satisfaction (P \ 0.05), suggesting these complications were not trivial to the patient. The results indicate that, just like outcome, ''complications'' should be assessed from both the patient's and the surgeon's perspectives, not least to better understand the reasons accounting for dissatisfaction and a poor patient-rated outcome.

A comparison of outcomes of cervical disc arthroplasty and fusion in everyday clinical practice: surgical and methodological aspects

“…The influence of the specific design of prosthesis should also be further investigated; in the present study, all types of prostheses were examined as one group and compared with all techniques of fusion-a possible limitation from the scientific methodology point of view, but a pragmatic approach that ideally reflected the everyday practice of a large Spine Center. Our data on patient self-assessed re-operation rates and complications after surgery-a relatively new concept in the field of outcomes research, and one that reveals some startling results [23]-suggested slightly more favourable results in the arthroplasty group, especially by 2 years FU; however, the group sizes were too small for meaningful statistical analyses of the data. Again, observational studies, using the data collected in large-scale registries such as the European Spine Tango, are well disposed to address some of these issues and to complement the findings of the RCTs.…”

Patient-rated Outcomes of Lumbar Fusion in Patients with Degenerative Disease of the Lumbar Spine: Does Age Matter?

“…Reports of the clinical outcome of geriatric patients (>80 years of age) who have undergone lumbar fusion are particularly rare. Patient-reported outcome measures help avoid bias in the reporting of surgical success [11][12][13] and provide an important insight into the impact of surgery from the patient's perspective 14 , allowing the collection of quantitative data regarding pain, function, and health-related quality of life 15 .…”

Patient-Rated Outcomes of Lumbar Fusion in Patients With Degenerative Disease of the Lumbar Spine

“…4,[7][8][9][10] Reports of the clinical outcome of geriatric patients (>80 years of age) who have undergone lumbar fusion are particularly rare. Patientreported outcome measures help avoid bias in the reporting of surgical success [11][12][13] and provide an important insight into the impact of surgery from the patient's perspective, 14 allowing the collection of quantitative data regarding pain, function, and health-related quality of life (QoL). 15 The aim of this study was to compare patient-rated outcome, complication rates, and length of hospital stay (LOS) among groups of younger (!50 years <65 years), older (!65 years <80 years), and geriatric (!80 years) patients undergoing lumbar fusion for degenerative disease.…”