Predictors of patient satisfaction following 1- or 2-level anterior cervical discectomy and fusion: insights from the Quality Outcomes Database

2019 ◽  
Vol 31 (6) ◽  
pp. 835-843
Author(s):  
Anthony L. Asher ◽  
Clinton J. Devin ◽  
Panagiotis Kerezoudis ◽  
Hui Nian ◽  
Mohammed Ali Alvi ◽  
...  
Keyword(s):  
Patient Satisfaction ◽  
Geographic Region ◽  
Anterior Cervical Discectomy ◽  
Symptom Duration ◽  
Insurance Status ◽  
Quality Outcomes ◽  
Surgical Practice ◽  
Cervical Discectomy ◽  
Patient Race ◽  
Compensation Status

OBJECTIVEPatient satisfaction with treatment outcome is gaining an increasingly important role in assessing the value of surgical spine care delivery. Nationwide data evaluating the predictors of patient satisfaction in elective cervical spine surgery are lacking. The authors sought to decipher the impacts of the patient, surgical practice, and surgeon on satisfaction with outcome following anterior cervical discectomy and fusion (ACDF).METHODSThe authors queried the Quality Outcomes Database for patients undergoing 1- to 2-level ACDF for degenerative spine disease since 2013. Patient satisfaction with the surgical outcome as measured by the North American Spine Society (NASS) scale comprised the primary outcome. A multivariable proportional odds logistic regression model was constructed with adjustments for baseline patient characteristics and surgical practice and surgeon characteristics as fixed effects.RESULTSA total of 4148 patients (median age 54 years, 48% males) with complete 12-month NASS satisfaction data were analyzed. Sixty-seven percent of patients answered that “surgery met their expectations” (n = 2803), while 20% reported that they “did not improve as much as they had hoped but they would undergo the same operation for the same results” (n = 836). After adjusting for a multitude of patient-specific as well as hospital- and surgeon-related factors, the authors found baseline Neck Disability Index (NDI) score, US geographic region of hospital, patient race, insurance status, symptom duration, and Workers’ compensation status to be the most important predictors of patient satisfaction. The discriminative ability of the model was satisfactory (c-index 0.66, overfitting-corrected estimate 0.64).CONCLUSIONSThe authors’ results found baseline NDI score, patient race, insurance status, symptom duration, and Workers’ compensation status as well as the geographic region of the hospital to be the most important predictors of long-term patient satisfaction after a 1- to 2-level ACDF. The findings of the present analysis further reinforce the role of preoperative discussion with patients on setting treatment goals and realistic expectations.

scholarly journals Predictors of Patient Satisfaction Following One- or Two-Level Anterior Cervical Discectomy and Fusion: Insights From the Quality Outcomes Database

Neurosurgery ◽  
2019 ◽  
Vol 66 (Supplement_1) ◽  
Author(s):  
Panagiotis Kerezoudis ◽  
Anthony L Asher ◽  
Clinton J Devin ◽  
Mohammed A Alvi ◽  
Inamullah Khan ◽  
...  
Keyword(s):  
Patient Satisfaction ◽  
Anterior Cervical Discectomy ◽  
Patient Specific ◽  
Symptom Duration ◽  
Insurance Status ◽  
Worker's Compensation ◽  
Cervical Discectomy ◽  
Worker’S Compensation ◽  
Patient Race ◽  
The Impact

Abstract INTRODUCTION Patient satisfaction with the outcome is gaining an increasingly important role in assessing the value of surgical spine care delivery. There is a lack of nationwide data evaluating the predictors of patient satisfaction in elective cervical spine surgery. The aim of this study was to decipher the impact of patient, practice, and surgeon on satisfaction with outcome following anterior cervical discectomy and fusion (ACDF). METHODS We queried the Quality Outcome Database for patients undergoing 1 to 2 level ACDF for degenerative spine disease since 2013. Patient satisfaction with the surgical outcome as measured by the North American Spine Society (NASS) scale comprised the primary outcome. A multivariable proportional odds logistic regression model was constructed adjusting for baseline patient characteristics, practice ID and surgeon ID characteristics as fixed effects. RESULTS A total of 4148 patients (median age 54 yr, 48% males) with complete 12-mo NASS satisfaction data were analyzed. Sixty-seven percent of patients answered that “surgery met their expectations” (n = 2803), while 20% “did not improve as much as they had hoped but they would undergo the same operation for the same results” (n = 836). After adjusting for a multitude of patient specific as well as hospital and surgeon related factors, we found baseline NDI score, region of hospital, patient race, insurance status, symptom duration, and worker's compensation to be the most important predictors of patient satisfaction. The discriminative ability of the model was satisfactory (c-index = 0.66, overfitting-corrected = 0.64). CONCLUSION Our results found baseline NDI score, patient race, insurance status, symptom duration, worker's compensation as well as region of hospital to be the most important predictors of long-term patient satisfaction after a 1 to 2 level ACDF. The findings of the present analysis further reinforce the role of preoperative discussion with the patients on setting treatment goals and realistic expectations.

Patient Satisfaction After Anterior Cervical Discectomy and Fusion Is Primarily Driven by Relieving Pain

2012 ◽  
Vol 28 (5) ◽  
pp. 398-403 ◽  
Author(s):  
Christian Hessler ◽  
Katharina Boysen ◽  
Jan Regelsberger ◽  
Eik Vettorazzi ◽  
Dietrich Winkler ◽  
...  
Keyword(s):  
Patient Satisfaction ◽  
Anterior Cervical Discectomy ◽  
Cervical Discectomy

scholarly journals Need for post-operative outpatient appointments after discharge following cervical spinal surgery - a narrative review

2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Karel de Bree ◽  
Femke Atsma ◽  
Erik J. van Lindert ◽  
Gert P. Westert ◽  
Ronald M. H. A. Bartels
Keyword(s):  
Patient Satisfaction ◽  
Outpatient Clinic ◽  
Spinal Surgery ◽  
Narrative Review ◽  
Anterior Cervical Discectomy ◽  
Outpatient Appointment ◽  
Cervical Discectomy ◽  
Beneficial Effects ◽  
Outpatient Appointments

Abstract Background In the Netherlands most patients are currently seen in an outpatient clinic after an anterior cervical discectomy, which is an effective neurosurgical procedure with relatively low rate of severe complications. In this back sight, the need for patients returning to the post-operative outpatient clinic could be questioned. The aim of the study is to evaluate whether a post-operative outpatient appointment after anterior cervical discectomy could be replaced by an alternative or be omitted without adversely impacting, or increasing, the value of healthcare and patient satisfaction for this procedure. Methods A narrative review was performed to evaluate the quality of care and patient satisfaction for patients with and without a post-operative outpatient appointment after spinal surgery. A literature search of the previous ten years was performed in Pubmed, CENTRAL and EMBASE. Results A total of 403 articles were identified. Four studies remained after title and abstract selection by 3 independent reviewers. No papers were selected for further analysis, due to the absence of interventional studies that compared the utility of a post-operative outpatient clinic appointment with an intervention after spinal surgery. Conclusions Currently, there is a lack of evidence for the need of a post-operative follow-up after anterior cervical discectomy. Nor is there any literature in favor of omitting these appointments. No determinants which patients benefits from these outpatient appointments could be identified. Potential harmful and beneficial effects of omitting these post-operative follow-ups should be investigated to identify possible determinant for patients who might benefit from a post-operative appointment.

Anterior cervical discectomy: is fusion necessary?

1999 ◽  
Vol 90 (1) ◽  
pp. 8-12 ◽  
Author(s):  
Gregory C. Dowd ◽  
Fremont P. Wirth
Keyword(s):  
Patient Satisfaction ◽  
Cervical Spondylosis ◽  
Operative Time ◽  
Length Of Hospital Stay ◽  
Activity Level ◽  
Anterior Cervical Discectomy ◽  
Content Type ◽  
Cervical Discectomy ◽  
Fusion Procedure ◽  
Fine Print

Object. A prospective, randomized trial was performed to compare the efficacy of anterior cervical discectomy (ACD) with ACD and fusion (ACDF) for the treatment of cervical spondylosis in patients with neurological compromise. Methods. Forty-four patients underwent ACD and 40 underwent ACDF. Operative time and length of hospital stay were shorter and there was less need for analgesia in the ACD group. It was found that whereas the incidence of fusion was greater in the ACDF group compared to the ACD group (97 compared with 70%, respectively; p < 0.01), patient satisfaction and a return to preoperative activity level was similar between groups. Conclusions. Analysis of the results suggests that the addition of a fusion procedure may be unnecessary.

scholarly journals Impact of Age and Duration of Symptoms on Surgical Outcome of Single-Level Microscopic Anterior Cervical Discectomy and Fusion in the Patients with Cervical Spondylotic Radiculopathy

2014 ◽  
Vol 2014 ◽  
pp. 1-6 ◽  
Author(s):  
Farzad Omidi-Kashani ◽  
Ebrahim Ghayem Hasankhani ◽  
Reza Ghandehari
Keyword(s):  
Surgical Outcome ◽  
Anterior Cervical Discectomy ◽  
Symptom Duration ◽  
Duration Of Symptoms ◽  
Cervical Discectomy ◽  
Single Level ◽  
Cervical Spondylotic Radiculopathy ◽  
Significant Difference ◽  
The Impact

We aim to evaluate the impact of age and duration of symptoms on surgical outcome of the patients with cervical spondylotic radiculopathy (CSR) who had been treated by single-level microscopic anterior cervical discectomy and fusion (ACDF). We retrospectively evaluated 68 patients (48 female and 20 male) with a mean age of 41.2±4.3 (ranged from 24 to 72 years old) in our Orthopedic Department, Imam Reza Hospital. They were followed up for 31.25±4.1 months (ranged from 25 to 65 months). Pain and disability were assessed by Visual Analogue Scale (VAS) and Neck Disability Index (NDI) questionnaires in preoperative and last follow-up visits. Functional outcome was eventually evaluated by Odom’s criteria. Surgery could significantly improve pain and disability from preoperative 6.2±1.4 and 22.2±6.2 to 3.5±2.0 and 8.7±5.2 (1–21) at the last follow-up visit, respectively. Satisfactory outcomes were observed in 89.7%. Symptom duration of more and less than six months had no effect on surgical outcome, but the results showed a statistically significant difference in NDI improvement in favor of the patients aged more than 45 years (P=0.032), although pain improvement was similar in the two groups.

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