Reconstructive spinal surgery: assessment of outcome

One of the foremost problems in evaluating patients who have had spinal surgery is the difficulty in reliably assessing changes in symptoms and function attributable to the operative procedure. In this study, a questionnaire was sent to patients who had had spinal surgery at least 6 months earlier. The data were entered into a data base that contained information about the surgical procedure. Correlation studies were conducted and t tests were used to find statistically significant differences. Seventy-two patients returned the completed questionnaire. The rate of return to work was significantly lower among those involved in workers' compensation or litigation and those with prolonged preoperative unemployment. Depression inversely correlated with satisfaction, the number of dissatisfied patients correlating directly with the number of patients significantly depressed. Physical deconditioning, change in attitude and perception, preinjury job dissatisfaction, secondary gain, and other medical conditions significantly decreased the probabilities of return to work and satisfaction.