Patient Reported Outcomes in Spine Surgery – The Wealth of Data

Introduction: While the value of patient-reported outcomes (PROs) regarding assessing patient and quality-of-care outcomes is increasingly recognized within spine surgery, the benefits and challenges associated with the collection and clinical use of PROs remain to be established. This review aims to discuss the published evidence on the wealth of clinically relevant data provided by PRO measures within spine surgery.

Methods: The peer-reviewed literature was searched for articles investigating the value of PRO data within spine surgery. Articles evaluating the collection and clinical use of PRO data within spine surgery, especially with respect to monitoring clinical and quality-of-care outcomes, were critically analyzed.

Results: While postoperative outcomes after spine surgery previously relied on the physician’s evaluation of a patient's physical recovery, in 1978, a new evaluation scheme for patients undergoing surgery for lumbar spinal stenosis shifted the weight of postoperative outcome evaluation from objective physical measures to measures that depended on the party performing the evaluation, including the physician, patient, or family. Currently, several standardized PRO scales whose performance has been rigorously investigated in validation studies are utilized to assess patients’ perception of pain, functional and psychometric outcomes after spine surgery. Overall, the benefits of using PROs in these patients include establishing patient involvement in their care, strengthening patient-provider rapport, and promoting patient-centered care, while further standardizing patient outcomes by incorporating the self-reported aspect of clinical outcomes into standardized outcome measures and creating a framework for further quality outcomes research and healthcare policymaking.

Conclusion : Physician-reported outcomes are often unable to provide a comprehensive evaluation of clinical and quality-of-care outcomes within spine surgery. Incorporation of PROs in patient evaluation is an integral part of efforts aimed at achieving excellence in healthcare delivery, as PROs help gain insight into individual patients’ experiences and integrate an appraisal of patients’ perspectives into clinical practice.