Factors influencing patients’ decisions to undergo recommended spinal surgery
##plugins.themes.bootstrap3.article.main##
Abstract
Spinal surgery is the final option recommended to individuals with spinal conditions when conservative treatment has failed in treating patients’ symptoms. In this prospective study, we examined 21 patients agreeing to undergo recommended spinal fusion between August 2021 and January 2022 with a virtual questionnaire. The mean age was 61.2 years. The majority of patients were male (13 patients, 61.9%), white (19 patients, 90.5%), and privately insured (11 patients, 52.4%). Patients reported that the most important factor contributing to their interest in surgery was the severity of symptoms (14 patients, 66.7%), confidence in the neurosurgeon (4 patients, 19%), and evaluation of potential adverse outcomes (3 patients, 14.3%). Their ideal outcome in consulting with a neurosurgeon for their symptoms was surgery (16 patients, 76.2%), exercise for pain relief (2 patients, 9.5%), and being told their problem is not a neurosurgical condition (3 patients, 14.3%). There is a multitude of factors that influence patients’ choices to undergo spinal surgery. These findings suggest that even though not all patients felt that surgery was their ideal outcome, all of them underwent surgery. Additional evaluations are needed to explore patients’ trust in neurosurgeons’ recommendations.
##plugins.themes.bootstrap3.displayStats.downloads##
##plugins.themes.bootstrap3.article.details##
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
This open-access article is distributed under a Creative Commons Attribution (CC-BY) 4.0 license.
You are free to: Share — copy and redistribute the material in any medium or format. Adapt — remix, transform, and build upon the material for any purpose, even commercially. The licensor cannot revoke these freedoms as long as you follow the license terms.
Under the following terms: Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.
No additional restrictions You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.
How to Cite
References
Gómara-Toldrà, N., Sliwinski, M., & Dijkers, M. P. (2014). Physical therapy after spinal cord injury: a systematic review of treatments focused on participation. The journal of spinal cord medicine, 37(4), 371–379. https://doi.org/10.1179/2045772314Y.0000000194
Lam, W. W., & Loke, A. Y. (2017). Factors and concerns of patients that influence the decision for spinal surgery and implications for practice: A review of literature. International journal of orthopaedic and trauma nursing, 25, 11–18. https://doi.org/10.1016/j.ijotn.2016.09.001
Atlas, A., Milanese, S., Grimmer, K., Barras, S., & Stephens, J. H. (2019). Sources of information used by patients prior to elective surgery: a scoping review. BMJ open, 9(8), e023080. https://doi.org/10.1136/bmjopen-2018-023080
Kleinman I. (1991). The right to refuse treatment: ethical considerations for the competent patient. CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne, 144(10), 1219–1222.
Lu, P. W., Fields, A. C., Yoo, J., Irani, J., Goldberg, J. E., Bleday, R., & Melnitchouk, N. (2020). Sociodemographic predictors of surgery refusal in patients with stage I-III colon cancer. Journal of surgical oncology, 121(8), 1306–1313. https://doi.org/10.1002/jso.25917
Nuwer, M. R., & Schrader, L. M. (2019). Spinal cord monitoring. Handbook of clinical neurology, 160, 329–344. https://doi.org/10.1016/B978-0-444-64032-1.00021-7
Kof. C. (2019). Preoperative Frailty Evaluation: A Promising Risk-stratification Tool in Older Adults Undergoing General Surgery. Clinical therapeutics, 41(3), 387–399. https://doi.org/10.1016/j.clinthera.2019.01.014
Torres, G., Relf, M. V., & Tuazon, J. A. (2020). The mediating role of pre-operative patient readiness on surgical outcomes: A structural equation model analysis. Journal of advanced nursing, 76(6), 1371–1383. https://doi.org/10.1111/jan.14339
Behairy, Y. M., Al-Shehri, H., Al-Azzam, S. A., & Al-Zahrani, A. G. (2003). A survey of patients attitude toward low back surgery in a major center in Saudi Arabia. Saudi medical journal, 24(6), 594–597.
Fowler, A. J., Abbott, T., Prowle, J., & Pearse, R. M. (2019). Age of patients undergoing surgery. The British journal of surgery, 106(8), 1012–1018. https://doi.org/10.1002/bjs.11148
Mocanu V, Kuper TM, Marini W, et al. Intersectionality of Gender and Visible Minority Status Among General Surgery Residents in Canada. JAMA Surg. 2020;155(10):e202828. doi:10.1001/jamasurg.2020.2828
Karlson, E. W., Daltroy, L. H., Liang, M. H., Eaton, H. E., & Katz, J. N. (1997). Gender differences in patient preferences may underlie differential utilization of elective surgery. The American journal of medicine, 102(6), 524–530. https://doi.org/10.1016/s0002-9343(97)00050-8
Noel, O. F., Berg, A., Onyango, N., & Mackay, D. R. (2020). Ethnic and Gender Diversity Comparison between Surgical Patients and Caring Surgeons. Plastic and reconstructive surgery. Global open, 8(10), e3198. https://doi.org/10.1097/GOX.0000000000003198
Best, M. J., McFarland, E. G., Thakkar, S. C., & Srikumaran, U. (2021). Racial Disparities in the Use of Surgical Procedures in the US. JAMA surgery, 156(3), 274–281. https://doi.org/10.1001/jamasurg.2020.6257
Wahood, W., Alexander, A. Y., Alvi, M. A., Goyal, A., Habermann, E. B., & Bydon, M. (2021). Is the current insurance structure leading to seasonality in demand for spinal surgery? A quarterly, yearly, and insurance based analysis. Clinical neurology and neurosurgery, 201, 106429. https://doi.org/10.1016/j.clineuro.2020.106429
Convie, L.J., Carson, E., McCusker, D. et al. The patient and clinician experience of informed consent for surgery: a systematic review of the qualitative evidence. BMC Med Ethics 21, 58 (2020). https://doi.org/10.1186/s12910-020-00501-6