Managing High Expectations Before Spine Surgery

Some patients are more likely than others to have high expectations prior to surgery for lumbar spondylolisthesis — make sure to suss them out

Smart Practice: High expectations before degenerative L-spine surgery were associated with high levels of physical activity, poorer overall health, and high levels of leg pain; pay particular attention when counseling patients with those traits, since high expectations before surgery risk disappointment afterward.

What’s the Claim?

A large longitudinal study from Canada found that a high level of physical activity was tightly correlated with high expectations before lumbar degenerative spondylolisthesis surgery (decompression with or without fusion). More medical comorbidities and more leg pain were also correlated with high expectations before surgery — these may have been separate groups of patients, though the study is silent on this, since it’s unlikely that patients with lots of comorbidities also were very active.

The two operations — again, decompression with or without fusion — did not differ in terms of preoperative expectations or postoperative expectation fulfillment. Unfortunately, this study was silent on whether high expectations before surgery were associated with a lower likelihood of patient satisfaction afterwards.

How’s It Stack Up?