ArticleClinical spine surgery2016
Spinal Stenosis: Factors That Influence Patients' Decision to Undergo Surgery.
Article in Clinical spine surgery, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
2 citing papers in PubMed.
- Adult cervical spine deformity: a state-of-the-art review.Spine deformity · 2024Review
- Shared decision-making in neurosurgery: a scoping review.Acta neurochirurgica · 2021Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors.
Funding
Abstract
STUDY
designProspective noninterventional observation.
objectiveTo examine factors that influence a patient's real decision to accept the offer of surgery for lumbar spinal stenosis in a relatively controlled situation. SUMMARY OF BACKGROUND DATA: A patient's decision to undergo spine surgery might be influenced by factors other than pathology. However, there is limited research exploring the decision.
methodsA study performed for other purposes recruited persons aged 55-90 years with medical record evidence of an offer of surgery for spinal stenosis by a university faculty surgeon. Inclusion criteria included neurogenic claudication, subjectively positive imaging, and difficulty walking 200 yards. Potential subjects with additional disabling conditions (eg, lower limb amputation), conditions that might mimic stenosis (eg, polyneuropathy), or some contraindications to invasive treatment (eg, anticoagulation) were excluded. Subjects filled out questionnaires on function, quality of life, pain, and health, and were examined by a spine surgeon masked to diagnostic category (Other recruits had back pain or no symptoms). Telephone follow-up 6-12 months later determined whether surgery was done.
resultsOf 39 qualifying subjects, 20 followed through with surgery. A binary logistic regression revealed that significant factors that influence patient decision making included SF-36 measures of "Comparative Health" and "Role Limit Emotional" as well as the subject's overall perception of their quality of life. The combination of all 3 factors yielded a predictive model (P=0.031). Individually, however, only "Comparative Health" was significant and able to predict a decision to proceed with surgery (P=0.036).
conclusionsIn this population with significant disability, uncomplicated medical history, and a relatively clear diagnosis, the decision to accept surgical intervention was influenced by issues of perceived overall health and quality of life. Interventions to change real or perceived overall health may impact patient acceptance of surgery.
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