The Impact of Unmet Expectations on Patient Satisfaction in Minimally Invasive Lumbar Spine Surgery

Introduction: With the rise of minimally invasive lumbar surgeries in the U.S., understanding factors influencing patient satisfaction is crucial. This study assesses the correlation between discrepancies in patient expectations and outcomes, and overall satisfaction among those undergoing minimally invasive lumbar decompression surgery. Additionally, it explores the relationship between other patient-reported outcomes (PROs) and satisfaction.

Methods: A prospective cohort study was conducted on patients undergoing elective, minimally invasive one- or two-level lumbar decompression surgeries. Preoperative and postoperative data were collected using the Musculoskeletal Outcome Data Evaluation and Management System (MODEMS) survey, the Short Form-36 Health Survey (SF-36), and a Likert scale for patient satisfaction. Surveys were completed preoperatively and at 6 weeks and 3 months postoperatively. Spearman’s correlation analysis assessed the relationship between expectation-outcome mismatch, changes in SF-36 subcategories, and satisfaction.

Results: Among 44 patients completing the 3-month follow-up, a significant negative correlation was found between expectation-actuality mismatch and patient satisfaction (ρ = -0.762, P < .001). Of the eight SF-36 subcategories, five showed significant correlations with satisfaction: physical function (ρ = -0.532, P < 0.001), role limitation due to physical health (ρ = -0.366, P < 0.05), energy/fatigue (ρ = -0.399, P < 0.01), social functioning (ρ = -0.491, P < 0.01), and pain (ρ = -0.637, P < 0.001).

Conclusion : This study demonstrates a strong negative correlation between expectation-outcome mismatch and patient satisfaction in minimally invasive lumbar surgery. Additionally, significant negative correlations were found between changes in several SF-36 subcategories and satisfaction. These findings highlight the importance of aligning patient expectations with likely outcomes to enhance satisfaction and improve recovery experiences.