Prospective evaluation of preoperative concerns for Chinese patients with spinal degenerative disease

Objective of this study is to analyze preoperative concerns of patients suffering from spinal degenerative disease in a Chinese population. A total of 94 patients with spinal degenerative disease were included, and they were divided into four groups: male and female group, older (≥60 year-old) and younger group (<60 year-old). Questionnaire was designed through patients counseling, preliminary formulation, pilot test and final revision. Each patient was required to select three items of greatest concern. "Attention rate" (AR) was defined as ratio of selected times of one item upon case number within the group. AR of three most concerned items between male and female group, as well as older and younger group were compared and analyzed. All participants selected "recurrence of symptoms following operation" (41/94), "clinical outcome" (35/94) and "postoperative rehabilitation and daily activity" (30/94) as their three top items of concern. Both male and female groups selected "recurrence of symptoms following operation" (22/47, 19/47), "clinical outcome" (21/47, 14/47), "postoperative rehabilitation and daily activity" (15/47, 15/47) and "limb paralysis" (13/47, 14/47) as their most concerned items, revealing no statistical difference (P>0.05). Older group chose "clinical outcome" (17/46) as their most concerned item, followed by "limb paralysis" (14/46), "postoperative rehabilitation and daily activity" (14/46) and "recurrence of symptoms following operation" (12/46). Younger group chose "recurrence of symptoms following operation" (29/48), "clinical outcome" (18/48) and "postoperative rehabilitation and daily activity" (16/48) as their three top concerned items. AR of "recurrence of symptoms following operation" between older and younger group demonstrated statistical difference (P<0.001), while AR of remaining items of greatest concern between both groups were not statistically different (P>0.05). For Chinese patients, high level concerns are associated with surgical outcome and most of them reveal no gender-associated or age-associated difference. Assessing preoperative concerns empowers better preoperative counseling between surgeons and patients and more informed decision for patients.