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Author Spotlight: Scope of LE-ULBD as a Safe, Effective, and Minimally Invasive Approach to Treat Lumbar Spinal Stenosis
Published on: February 9, 2024
A population-based survey of lumbar surgery beliefs in the United States
Merrill R Landers1, Emilio Puentedura, Adriaan Louw
1Merrill R. Landers, PT, DPT, PhD, OCS, Chair and Associate Professor, Department of Physical Therapy, University of Nevada Las Vegas. Emilio Puentedura, PT, DPT, PhD, GDMT, OCS, FAAOMPT, Associate Professor, Department of Physical Therapy, University of Nevada Las Vegas. Adriaan Louw, PT, MAppSc, GCRM, CSMT, PhD, Chief Executive Officer and Senior Faculty, International Spine and Pain Institute, Story City, Iowa. Amanda McCauley, DPT, Physical Therapist, Department of Physical Therapy, University of Nevada Las Vegas. Zak Rasmussen, DPT, Physical Therapist, Department of Physical Therapy, University of Nevada Las Vegas. Tim Bungum, DrPH, Associate Professor, Department of Occupational and Environmental Health, School of Community Health Sciences, University of Nevada, Las Vegas.
Introduction:
Studies have shown that lumbar surgery (LS) outcomes may be influenced by perception. However, the perceptions of the general population regarding LS are not known. Therefore, the purpose of this study was to investigate the general population's perceptions regarding LS.
Subjects:
This study included 262 participants (mean age: 46.1 years; 125 males and 137 females) from the Las Vegas (NV) metropolitan area.
Methods:
A questionnaire was developed by an expert panel and was assessed for face and content validity. After revision and establishment of test-retest reliability, participants were surveyed at 12 randomly selected grocery stores in Las Vegas. The questionnaire assessed demographics, personal and family medical history, and 11 items pertaining to perceptions of LS.
Results:
The participants had a somewhat uncertain expectation about the potential success of LS; however, approximately two-thirds believed that LS is unsuccessful to the point that they would not be able to return to their previous level of activity after LS. Of the questions dealing with success of LS, the neutral response had the greatest frequency suggesting a lack of knowledge or uncertainty about LS. More than half of the respondents were fearful of LS and anticipated a protracted recovery accompanied by undesired side effects. Three quarters of the respondents agreed that they would try all other means of treatment before opting for LS, yet 39% said that they would undergo LS if they had severe lower back pain (LBP).
Conclusions:
The general population has an uncertain view of LS outcomes and anticipates postoperative side effects and a protracted recovery; these views may explain why a majority of participants expressed fear of LS and why most would only opt for LS as a last resort. This uncertainty and anticipation of poor outcomes may be a strong contributor to preoperative fear and anxiety, which could deleteriously influence postoperative outcomes.
