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Discrepancies Between Patient and Surgeon Expectations of Surgery for Sciatica: A Challenge for Informed Decision
Yasir Rehman1,2,3, Muzammil Syed4, Wojtek Wiercioch1
1Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada.
Spine
|November 6, 2018
Summary
Patients undergoing lumbar decompressive surgery for sciatica often misunderstand risks and benefits, relying on external information for decisions. Improved surgeon communication regarding prognosis and activity modifications is crucial for informed decision-making.
Area of Science:
- Spine Surgery
- Patient Decision-Making
- Health Communication
Background:
- Inconsistent evidence on pain improvement after lumbar decompressive surgery for sciatica.
- Patients accept surgical risks despite uncertain benefits, questioning informed consent.
- Need to understand patient and surgeon perceptions of risks and benefits.
Purpose of the Study:
- Compare patient and surgeon perceptions of lumbar decompressive surgery risks and benefits.
- Investigate informed decision-making processes for sciatica surgery.
- Identify communication gaps in surgical consultations.
Main Methods:
- Qualitative descriptive study.
- 12 adult lumbar decompressive surgery candidates and 6 spine surgeons participated.
- Inductive content analysis of interview data.
Main Results:
- Most patients were satisfied with consultations but had limited understanding of the surgery.
- Discrepancies noted between patient expectations/understanding and surgeon's perceived communication.
- Patients desired more information on post-surgical activity and long-term outcomes than surgeons provided.
Conclusions:
- Significant misunderstandings exist between patients and surgeons regarding prognosis and activity modifications.
- Enhanced communication is vital for informed decisions about sciatica surgery.
- Findings offer guidance for improving informed consent in elective surgeries.
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