[The outcome of surgery for spinal stenosis in Swedish hospitals]

In a local and national quality control study based on Swespine the rate of satisfied patients and the rate of patients with reduced leg pain after surgery for spinal stenosis at Nacka Hospital was 70,5 % and 62,3 %, respectively, compared to 67,8 % and 60,5 % nationally. The rate was unchanged locally as well as nationally 2009-2019. Controlling for mix of patients by multiple regression analysis greatly reduced all differences between Swedish clinics with no statistically significant differences between them. Private clinics, assessed as a group, had a slight but significant improved outcome compared to public hospitals, 68,8 % compared to 64,8 % satisfied patients. PROMs are to a substantial degree affected by factors other than the surgical procedure per se, and should be interpreted with great caution in outcome assessments of degenerative spine surgery. The study underlines the need of objective outcome measures.