The influence of grit on long-term outcomes after lumbar surgery: a pilot study

Resilience has been shown to impact surgical outcomes across many diseases. The "Grit Scale score" has been used to quantify a more sustained resilience by examining commitment to long-term goals and perseverance. We assessed the influence of grit on long-term patient-reported outcomes after multilevel lumbar spine surgery for degenerative conditions.

In this cohort study, 21 adults who had ≥3 years of follow-up after lumbar spine surgery were classified as "Gritty" (Grit Scale score ≥3.8) or "Not Gritty" (<3.8). Patient-reported outcomes were measured at baseline and at multiple intervals up to 5 years postoperatively and compared between cohorts.

The mean grit scores differed significantly between the two groups (Gritty 4.15 ± 0.25 vs. Not Gritty 3.26 ± 0.33, p < 0.001), and the cohorts were otherwise demographically and clinically comparable. The Gritty group reported significantly greater improvements in EuroQoL-5D scores at 12 months (+28 % vs. -15 %, p = 0.034), 24 months (+34 % vs. -9 %, p = 0.044), and 36 months (+32 % vs. 0 %, p = 0.016). Additionally, back pain scores were lower in the Gritty group at 12 months (p = 0.016). No significant differences were observed for Oswestry Disability Index or rates of minimal clinically important difference achievement. Secondary outcomes, including length of hospital stay, complications, and reoperations, were comparable.

Higher grit scores correlated with better long-term quality of life and reduced back pain at selected intervals after lumbar spine surgery, without differences in disability scores or secondary outcomes. Considering the study's pilot nature and limited sample size, further investigation with larger cohorts is merited to clarify the role of grit in recovery.