Patients’ perspective regarding surgical management for lumbar spinal stenosis: a qualitative study

Abstract

Introduction: While lumbar spinal stenosis (LSS) is the most common degenerative condition that leads to spine surgery in older adults, little is known with regards to patients’ concern regarding LSS surgery and recovery. The current qualitative research aimed to understand LSS patients’ perspective regarding (1) their concerns before spine surgery; (2) perceived treatment effects of surgery, and (3) factors affecting their recovery. Materials and Methods: Sixteen LSS patients at 6 months after spine surgery were recruited to participate in focus groups or semi-structured interviews. Two facilitators asked open-ended questions related to the three research questions. Transcripts were coded and thematic analysis were performed. Results: Five themes were identified. First, physicians and friends/relatives greatly affected patients’ decision on LSS surgery. Second, patients had a strong desire to learn information related to LSS but they did not know how to find relevant information. Third, surgery could relieve symptoms but the effect might only be temporary. Fourth, regular postoperative exercise yielded less symptoms and better function. Fifth, factors affecting physical activity hindered patients’ recovery. Discussion and Conclusion: Since orthopaedic surgeons have strong influence on patients, they can play an important role in providing proper preoperative LSS education to reduce patients’ uncertainty and enhance patients’ postoperative recovery. Importantly, since patients performing regular exercise (e.g., hiking) demonstrate better clinical outcomes, clinicians should encourage patients to adopt a regular exercise habit to enhance their recovery and self-management of postoperative residual symptoms.