Patient satisfaction with outpatient lumbar microsurgical discectomy: a qualitative study

Lumbar microsurgical discectomy was traditionally done as an inpatient procedure, but over the last decade, there has been an ever-expanding shift toward outpatient lumbar microdiscectomy (OLM). We have been performing OLM since 1997 (MB) and 2002 (EMM), but no study of patient satisfaction has been carried out to date. the objective of our study was to investigate patient satisfaction with the experience.

Between September 2004 and March 2005, we carried out a qualitative case study at Toronto Western Hospital, involving interviews with 28 patients who had recently undergone OLM. The protocol was approved by the institutional Research Ethics Board, and informed consent was obtained from each participant. Interviews were transcribed and stored anonymously and subjected to modified thematic analysis by 5 reviewers.

Analysis of the interviews yielded several overarching themes: 1) patients are surprised that back surgery can be done on an outpatient basis; 2) the amount and quality of information they receive is satisfactory; 3) the overall experience is positive; 4) trust in one's surgeon is important; and 5) some patients have significant back pain in the early postoperative period.

Most patients appreciate the need for the health care system to save money where possible so that it can be spent in other, more resource-intensive areas. Outpatient lumbar microdiscectomy satisfies this goal while retaining high patient satisfaction rates. Qualitative research can yield substantial insight, which will improve the experience for future patients. Qualitative research is rare in the surgical literature and can answer questions quantitative research methods cannot.