The prognostic importance of patient pre-operative expectations of surgery for lumbar spinal stenosis
The prognostic importance of patient pre-operative expectations of surgery for lumbar spinal stenosis
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DOI：
10.1016/s0738-3991(97)00109-2
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发表时间：
1998-06-01
影响因子：
3.5
通讯作者：
Katz, JN
中科院分区：
文献类型：
--
作者：
Iversen, MD;Daltroy, LH;Katz, JN
心理社会变量对腰椎管狭窄症（LSS）手术结果的影响尚未得到评价。我们研究了257例LSS患者的术前和术后6个月：（a）将患者对手术的期望与基线功能和疼痛联系起来;（B）确定患者期望和术前功能如何相互作用以预测术后结局。结果：平均而言，患者经历了实质性的疼痛缓解，改善功能和满意度。术前期望值较高的患者，尤其是基线功能较低的患者，术后功能改善程度高于期望值较低的患者。对身体功能的更高期望也与6个月时的功能改善和满意度相关。相反，有更多的疼痛缓解的期望与更多的疼痛和疼痛缓解的满意度较低。结论：患者期望影响6个月时的手术恢复。为了改善结果和满意度，临床医生应在术前与患者讨论期望。(C)1998爱思唯尔科学爱尔兰有限公司
The influence of psychosocial variables in the outcome of surgery for lumbar spinal stenosis (LSS) has not been evaluated. We studied 257 patients with LSS pre-operatively and at 6 months to: (a) relate patient expectations of surgery to baseline function and pain; and (b) determine how patient expectations and pre-operative function interact to predict post-operative outcomes. Results: On average, patients experienced substantial pain relief, improved function and satisfaction. Patients with many pre-operative expectations, particularly patients with low baseline function, reported more improvement in postoperative function than patients with few expectations. More ambitious expectations for physical function were also associated with improved function and satisfaction at 6 months. Conversely, having more numerous pain relief expectations was associated with more pain and less satisfaction with pain relief. Conclusion: Patient expectations influence recovery from surgery at 6 months. To improve outcomes and satisfaction, clinicians should discuss expectations with patients pre-operatively. (C) 1998 Elsevier Science Ireland Ltd.