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Informed patients do better after spine surgery

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Spinal fusion is a surgical procedure in which two or more vertebrae are joined together so they heal into a single, solid bone — stopping movement between the bones and helping to prevent back pain.

In a new study reported at the 33rd Annual Meeting of the North American Spine Society (NASS), researchers found that patients do better after surgery when they know more about the procedure and have a full understanding of what to expect.

The retrospective study included 206 patients who received elective spinal fusion. Half of the patients participated in a two-hour education session three to six weeks prior to surgery, while the other half opted out of the educational session. There were no other significant differences between patients in the two groups.

During the class there were discussions with nursing, physiotherapy and occupational therapy staff focusing on what patients should expect, how to best prepare for surgery and proper care after surgery.

Follow-up showed that patients who took part in the pre-surgical education sessions were significantly more satisfied with their surgery than those in the control group.

Patients who did not participate in the education session failed to have their expectations met in terms of improvement in daily activities, improvement in walking capacity, and reduction in back pain.

There was also a statistically significant effect of participation in the class reducing postoperative back pain, although this improvement did not reach clinically significant levels.

The researchers concluded that participation in a single two-hour educational session prior to surgery significantly impacted patient satisfaction, expectations, level of disability, and back pain.

“We tend to think of improvements in health care as difficult and costly to achieve,” commented Donna M. Eastwood, the study’s lead author. “However, this study demonstrates that a simple and cost-effective, two-hour group class substantially improves patient satisfaction and outcomes after spinal fusion surgery. Spine surgeons should take note and invest in patient education if they would like to improve outcomes.”

Explaining why participating in the class led to so many positive outcomes, Eastwood said: “The class provided patients with an opportunity to engage with members of their care team in a non-threatening environment and have their specific questions and concerns addressed. By knowing what to expect, patients and families were better able to prepare for their surgery and recovery.”