Patient Satisfaction Following Minimally Invasive and Open Surgeries for Adult Spinal Deformity

Won Hyung A Ryu; Michael Cheong; Andrew Platt; Ziev Moses; John E O'Toole; Ricardo Fontes; Richard G Fessler

doi:10.1016/j.wneu.2021.08.047

Patient Satisfaction Following Minimally Invasive and Open Surgeries for Adult Spinal Deformity

World Neurosurg. 2021 Nov:155:e301-e314. doi: 10.1016/j.wneu.2021.08.047. Epub 2021 Aug 19.

Authors

Won Hyung A Ryu¹, Michael Cheong², Andrew Platt³, Ziev Moses², John E O'Toole², Ricardo Fontes², Richard G Fessler⁴

Affiliations

¹ Department of Neurological Surgery, Rush University, Chicago, Illinois, USA; Department of Neurological Surgery, Oregon Health & Science University, Portland, Oregon, USA.
² Department of Neurological Surgery, Rush University, Chicago, Illinois, USA.
³ Department of Neurological Surgery, University of Chicago, Chicago, Illinois, USA.
⁴ Department of Neurological Surgery, Rush University, Chicago, Illinois, USA. Electronic address: rfessler@rush.edu.

PMID: 34419662
DOI: 10.1016/j.wneu.2021.08.047

Abstract

Background: Patient satisfaction has become an important variable in assessing outcomes after spine surgery. Although minimally invasive surgery (MIS) techniques have become popular owing to reduced perioperative complications compared with open deformity surgery, whether patient-reported postoperative satisfaction differ between the 2 surgical approaches is unclear. The aim of this study was to characterize postoperative patient-reported outcomes (PRO) in patients who underwent open surgery or MIS for adult spinal deformity (ASD).

Methods: PRO scores were prospectively collected for patients undergoing deformity correction surgery between 2016 and 2018. Inclusion criteria were age >18 years, ASD, and completed PRO surveys. Patient demographic, clinical, and radiographic data and PRO survey responses were analyzed. A post hoc analysis comparing patients who were satisfied with their outcome and those who were unsatisfied was performed.

Results: Forty patients who underwent operative management of ASD (19 in the open surgery group and 21 in the MIS group) met the criteria for inclusion in this study. Patients in the MIS group reported higher mental health and self-image scores at 6 months; however, at the 12-month follow-up, both the open surgery and MIS groups reported minimal clinically important differences in back pain, leg pain, and functional status. Patient satisfaction scores did not differ based on surgical approach or intraoperative complications.

Conclusions: PRO after open surgery and after MIS for ASD reflected successful outcomes with significant improvements in PRO survey scores but with subtle differences in the postoperative recovery process. The MIS group reported faster recovery with earlier improvement in self-image and mental health scores, which may stem from correction of smaller deformities. At the 12-month follow-up, postoperative satisfaction was high for the majority of patients in both groups.

Keywords: Adult spinal deformity; Health-related quality of life; Patient satisfaction.

MeSH terms

Aged
Aged, 80 and over
Cohort Studies
Female
Follow-Up Studies
Humans
Male
Mental Health / trends*
Middle Aged
Minimal Clinically Important Difference
Minimally Invasive Surgical Procedures / psychology
Minimally Invasive Surgical Procedures / trends*
Pain Measurement / psychology
Pain Measurement / trends
Patient Reported Outcome Measures*
Patient Satisfaction*
Postoperative Care / psychology
Postoperative Care / trends
Prospective Studies
Quality of Life* / psychology
Spinal Diseases / psychology
Spinal Diseases / surgery*