Aligning Patient & Surgeon Expectations for Lumbar Spine to Improve Outcomes

Setting Expectations Before Spine Surgery Improves Outcomes

This study “Concordance between Patients’ and Surgeons’ Expectations of Lumbar Spine Surgery” found that 87% of lumbar spine surgery patients had more optimistic expectations of surgical outcomes than their surgeons did. As patient outcomes become more prevalent and available to payers and patients, surgeons need to evaluate how they setting patient expectations before surgery.

This study reveals that patients who have unrealistic expectations of their surgical outcome can have a detrimental impact on their ultimate outcomes. The findings show discussing expectations before surgery can address the amount of improvement and how patients can maximize the potential for positive outcomes.

Aligning patient and surgeon expectations can seem like a daunting task, developing a curriculum for patients based on their diagnosis and pre-op status to address realistic expectations for surgery can be quite simple. For example, the CODE PRO platform asks the following question to all elective orthopedic surgery patients 3 months postoperatively: ‘Was your pain better or worse than expected after the surgery?’ A few months after a surgeon has been using CODE, we regularly see a drastic transition from patients who report that the patient pain was ‘worse than expected’ to ‘as expected’ (and in some cases, to better than expected). This is all accomplished through pre-op education from the surgeon, setting the expectations with the patients that it’s going to hurt. And, one of the biggest trends that we have seen in patients who report that the results of the surgery met their expectations at the 3-month post-op mark, is you guessed it- pain.