Determinants of patient satisfaction after surgery for central spinal stenosis without concomitant spondylolisthesis: a register study of 5100 patients.

ABSTRACT

PURPOSE: Satisfaction with the outcome of treatment is a widely used outcome measure but information about the determinants of patient satisfaction after surgery for central spinal stenosis (CSS) are lacking. The aim of the study was to analyze determinants of patient satisfaction 1 year after surgery for CSS without degenerative spondylolisthesis (DS). METHODS: This prospective register study included 5100 patients operated for CSS without DS. 88 % received decompression only (D) and 12 % had decompression and fusion (DF). The patient reported outcome measures were the EuroQol-5D, the Short-Form 36, the visual analogue scale for leg and back pain, the Oswestry disability index and the self-estimated walking distance. Logistic regression reporting odds ratios (OR) for being satisfied was utilized. RESULTS: There were significant baseline differences between satisfied and dissatisfied patients in all patient reported outcome measures except leg pain. Factors decreasing the likelihood for satisfaction included previous spine surgery OR 0.4 (95 % CI 0.3-0.5), smoking OR 0.6 (95 % CI 0.4-0.8), unemployment OR 0.6 (95 % CI 0.4-0.9), back pain exceeding 1 year OR 0.6 (95 % CI 0.4-0.9), back pain predominance OR 0.7 (95 % CI 0.5-0.8). Fusion surgery did not predict satisfaction OR 1.3 (95 % CI 0.9-1.9). Preoperative self-estimated walking distance >1000 m predicted satisfaction, OR 2.4 (95 % 1.6-3.6). CONCLUSIONS: Numerous factors have predictive value for satisfaction of outcome after surgery for CSS without DS. The results from this study can constitute background data in the shared decision making process when discussing surgery with patients suffering from CSS.