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High Preoperative Expectations May Not Need to be Feared.

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Preoperative expectations for pain relief did not correlate with outcomes after anterior cervical surgery. However, preoperative dissatisfaction was linked to greater functional improvement, suggesting satisfaction may predict surgical benefit.

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Area of Science:

  • Spine surgery outcomes research
  • Patient-reported outcome measures
  • Cervical spine disorders

Background:

  • Limited data exists on the relationship between patient expectations and outcomes after anterior cervical spine surgery.
  • Understanding this relationship can help identify patients who may benefit most from surgical intervention.

Purpose of the Study:

  • To evaluate the correlation between preoperative expectations for pain relief and 12-month functional outcomes and patient satisfaction following primary anterior cervical surgery.
  • To explore the predictive value of preoperative expectations on surgical success.

Main Methods:

  • Retrospective study of 1-2 level primary anterior cervical discectomy and fusion (ACDF) or cervical disc arthroplasty (CDR) patients (2016-2021).
  • Preoperative pain relief expectations (5-point Likert) and satisfaction (7-point Likert) were assessed.
  • Linear regression models analyzed the association between expectations, 12-month Neck Disability Index (NDI) change, minimum clinically important difference (MCID) achievement, and satisfaction, controlling for covariates.

Main Results:

  • No significant correlation was found between preoperative pain relief expectations and 12-month NDI improvement or MCID achievement.
  • Preoperative expectations were not associated with 12-month patient satisfaction.
  • Greater preoperative dissatisfaction significantly correlated with greater 12-month NDI improvement.

Conclusions:

  • Preoperative expectations for pain relief do not predict functional outcomes or satisfaction after 1-2 level primary ACDF or CDR at 12 months.
  • Preoperative patient dissatisfaction is associated with greater functional improvement, suggesting it may be a better indicator of surgical benefit.
  • Assessing preoperative satisfaction, rather than expectations, may help identify patients most likely to benefit from cervical spine surgery.