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Consent for spine surgery: an observational study.

Angela Li Ching Ng1, Lucinda S McRobb2, Sarah J White3

  • 1Macquarie Neurosurgery, Macquarie University Clinic, Sydney, New South Wales, Australia.

ANZ Journal of Surgery
|October 6, 2020
PubMed
Summary
This summary is machine-generated.

Informed consent for spine surgery is inconsistent, with surgeons often failing to clearly explain risks and benefits. This impacts patient understanding and highlights a need for improved communication in surgical practice.

Keywords:
informed consentlumbarobservational studyriskspine surgery

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Area of Science:

  • Neurosurgery
  • Surgical Communication
  • Patient Safety

Background:

  • The ideal of informed consent in spine surgery contrasts with variable surgeon explanations and poor patient understanding.
  • Current practice for informed consent in spine surgery is under-investigated.
  • Patient interviews and surgeon surveys suggest a disconnect in the informed consent process.

Purpose of the Study:

  • To investigate the reality of informed consent in spine surgery.
  • To analyze risk/benefit discussions during informed consent for non-instrumented spine surgery.
  • To provide an authentic reflection of current informed consent practices.

Main Methods:

  • A prospective observational study at a single neurosurgical institution.
  • Video recording of twelve informed consent consultations for non-instrumented spine surgery.
  • Verbatim transcription and blind analysis using descriptive quantification and linguistic ethnography.

Main Results:

  • Surgical benefit was discussed in 83% of consultations, but only 41% quantified its likelihood.
  • Commonly discussed risks included nerve damage/paralysis (92%), bleeding (92%), and infection (92%).
  • While surgeons often quantified risk (58%), only half of risks were explained in understandable terms.

Conclusions:

  • Significant inconsistencies exist in how spine surgeons explain risks and obtain informed consent for common procedures.
  • Disparities in informed consent provision may extend to other surgical specialties.
  • Direct observation and qualitative analysis reveal limitations in current informed consent practices, guiding future improvements.