CLICK PIC

The Study: The assessment of complications after spine surgery: time for a paradigm shift?

The Facts:

a. Researchers are starting to place greater emphasis on the patient's perspective as to outcomes.

b. This is a prospective study which assessed complications following spinal surgery from the patient's perspective

c. The patients underwent surgery "for painful degenerative lumbar disorders."

d. 27% or the patients indicated they suffered complications.

e. 34% of patients reporting complications said their complication was "very" bothersome while 17% of those reporting complications rated their complication as "extremely" bothersome.

f. The most common complications were sensory disturbances and ongoing/new pain.

g. Interestingly, "More often than not, the complications reported by the patient were not documented by the surgeon..."

h. "Surgeons reported lower complication rates than the patients..."

Take Home:

I think the authors said it best, "...complications and severity should be assessed from both the patient's and surgeon's perspective."

Reviewer's Comments:

I think this is what we would expect. If you are a patient, you live with any remaining problems day after day. You know exactly how you feel. If you are the surgeon you have a snap shot look into the patient's life. It's a little like the old joke about ham and eggs for breakfast. The chicken is involved but the pig is committed. It doesn't mean that the surgeon did anything wrong or that the patient had unrealistic expectations. It just means that cutting into a spine is inherently fraught with dangers.

Reviewer: Roger Coleman DC

Reference: Mannion AF, Fekete TF, O'Riordan D, Porchet F, Mutter UM, Jeszensky D, Lattig F, Grob D, Kleinstueck FS. The assessment of complications after spine surgery: time for a paradigm shift? Spine J 2013 Jun;13(6):615-24

NOTE FROM KEEFE CLINIC: CHIROPRACTIC IS THE MOST EFFECTIVE TREATMENT ON THE PLANET FOR BACK PAIN!!!!