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Related Experiment Video

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Evaluation of Patients' Posture and Gait Profile After Lumbar Fusion Surgery by Video Rasterstereography and Treadmill Gait Analysis
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Validating Goal Attainment in Veterans Undergoing Decompressive Laminectomy: A Preliminary Study.

Keelin Moehl1, Dave Newman2, Subashan Perera3,4

  • 1School of Medicine.

Pain Medicine (Malden, Mass.)
|November 19, 2020
PubMed
Summary

Surgical success after decompressive laminectomy (DL) for lumbar spinal stenosis (LSS) in older adults doesn't always align with patient goals. Goal Attainment Scaling (GAS) showed patient goals were not fully met, despite positive surgical outcomes.

Keywords:
Decompressive LaminectomyGoal AttainmentVeterans

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Area of Science:

  • Neurosurgery
  • Geriatric Medicine
  • Rehabilitation Medicine

Background:

  • Decompressive laminectomy (DL) is common for lumbar spinal stenosis (LSS) in older adults.
  • Patient-centered care necessitates understanding if surgical success aligns with patient-defined goals.

Purpose of the Study:

  • To investigate the relationship between surgically defined functional recovery and patient-achieved personalized goals after DL for LSS.
  • To compare goal achievement using Goal Attainment Scaling (GAS) in patients undergoing DL.

Main Methods:

  • Twenty-eight community-dwelling veterans undergoing DL were enrolled.
  • Personalized 1-year post-DL goals were set pre-operatively; GAS and Brigham Spinal Stenosis (BSS) scores were assessed pre- and post-surgery.
  • GAS scores were transformed to GAS-T scores for standardized comparison.

Main Results:

  • Seventeen of 28 participants had successful DL outcomes per BSS standards.
  • No participants achieved all personalized GAS goals, with average follow-up GAS-T scores of 44.5.
  • BSS scales positively correlated with GAS-T change scores; fear-avoidance beliefs negatively correlated with GAS-T change.

Conclusions:

  • Congruent validity exists between GAS and BSS in older veterans undergoing DL for LSS.
  • Patient-centered care requires acknowledging the gap between surgical outcomes and patient goal achievement.
  • Further research with larger, diverse populations and other pain conditions is warranted to explore GAS.