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The bothersomeness of patient self-rated “complications” reported 1 year after spine surgery

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Abstract

Purpose

The last few decades have witnessed a paradigm shift in the assessment of outcome in spine surgery, with patient-centred questionnaires superseding traditional surgeon-based assessments. The assessment of complications after surgery and their impact on the patient has not enjoyed this same enlightened approach. This study sought to quantify the incidence and bothersomeness of patient-rated complications 1 year after surgery.

Methods

Patients with lumbar degenerative disorders, operated with the goal of pain relief between October 2006 and September 2010, completed a questionnaire 1 year postoperatively enquiring about complications arising as a consequence of their operation. They rated the bothersomeness of any such complications on a 5-point scale. Global outcome of surgery and satisfaction at the 12-month follow-up were also rated on 5-point Likert scales. The multidimensional Core Outcome Measures Index (COMI) was completed preoperatively and at the 12-month follow-up.

Results

Of 2,282 patients completing the questionnaire (92 % completion rate), 687 (30.1 %) reported complications, most commonly sensory disturbances (36 % of those with complications) or ongoing/new pain (26 %), followed by motor problems (8 %), pain plus neurological disturbances (11 %), and problems with wound healing (6 %). The corresponding “bothersomeness” ratings for these were: 1 % not at all, 23 % slightly, 27 % moderately, 31 % very, and 18 % extremely bothersome. The greater the bothersomeness, the worse the global outcome (Rho = 0.51, p < 0.0001), patient satisfaction (Rho = 0.44, p < 0.0001) and change in COMI score (Rho = 0.52, p < 0.0001).

Conclusion

Most complications reported by the patient are perceived to be at least moderately bothersome and hence are not inconsequential. Complications and their severity should be assessed from both the patient’s and the surgeon’s perspectives—not least to better understand the reasons for poor outcome and dissatisfaction with treatment.

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Acknowledgements

We are grateful to Gordana Balaban, Julian Amacker, Kirsten Clift, Sara Preziosa, and Selina Nauer for their help with the data collection.

Conflict of interest

None.

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Authors and Affiliations

  1. Spine Center Division, Department of Research and Development, Schulthess Klinik, Lengghalde 2, 8008, Zurich, Switzerland

    A. F. Mannion & D. O’Riordan

  2. Spine Center, Schulthess Klinik, Lengghalde 2, 8008, Zurich, Switzerland

    U. M. Mutter, F. T. Fekete, D. Jeszenszky, F. S. Kleinstueck, F. Lattig, D. Grob & F. Porchet

Authors
  1. A. F. Mannion
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  2. U. M. Mutter
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  3. F. T. Fekete
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  4. D. O’Riordan
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  5. D. Jeszenszky
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  6. F. S. Kleinstueck
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  7. F. Lattig
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  8. D. Grob
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  9. F. Porchet
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Correspondence to A. F. Mannion.

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Mannion, A.F., Mutter, U.M., Fekete, F.T. et al. The bothersomeness of patient self-rated “complications” reported 1 year after spine surgery. Eur Spine J 21, 1625–1632 (2012). https://doi.org/10.1007/s00586-012-2261-8

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  • DOI: https://doi.org/10.1007/s00586-012-2261-8

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