THE PROGNOSTIC IMPORTANCE OF PATIENT PREOPERATIVE EXPECTATIONS OF SURGERY FOR LUMBAR SPINAL STENOSIS

The influence of psychosocial variables in the outcome of surgery for lumbar spinal stenosis (LSS) has not been evaluated. We studied 257 pa tients with LSS pre-operatively and at 6 months to: (a) relate patient expectations of surgery to baseline function and pain; and (b) determ ine how patient expectations and pre-operative function interact to pr edict post-operative outcomes. Results: On average, patients experienc ed substantial pain relief, improved function and satisfaction. Patien ts with many pre-operative expectations, particularly patients with lo w baseline function, reported more improvement in postoperative functi on than patients with few expectations. More ambitious expectations fo r physical function were also associated with improved function and sa tisfaction at 6 months. Conversely, having more numerous pain relief e xpectations was associated with more pain and less satisfaction with p ain relief. Conclusion: Patient expectations influence recovery from s urgery at 6 months. To improve outcomes and satisfaction, clinicians s hould discuss expectations with patients pre-operatively. (C) 1998 Els evier Science Ireland Ltd.