Chan P1, Skaggs D, Sanders A, Villamor GA, Choi PD, Tolo V, Andras LM.
Author information
Abstract
STUDY DESIGN:
Prospective cross-sectional study OBJECTIVE.: To evaluate patients’ and parents’ concerns so they can be addressed with appropriate preoperative counseling.
SUMMARY OF BACKGROUND DATA:
Despite much research on outcomes for posterior spinal fusion (PSF) in adolescent idiopathic scoliosis (AIS), little is available about preoperative fears or concerns.
METHODS:
AIS patients undergoing PSF, their parents, and surgeons, were prospectively enrolled and asked to complete a survey on their fears and concerns about surgery at their preoperative appointment.
RESULTS:
Forty-eight patients and parents completed surveys. Four attending pediatric spine surgeons participated and submitted 48 responses. Mean age of patients was 14.2 years. On a scale of 0-10, mean level of concern reported by parents (6.9) was higher than that reported by patients (4.6). Surgeons rated the procedure’s complexity on a scale of 0-10 and reported a mean of 5.2. Neither patients’ nor parents’ level of concern correlated with the surgeons’ assessment of the procedure’s complexity level (R = 0.19 and 0.12, p = 0.20 and p = 0.42 respectively). Top 3 concerns for patients were pain (25%), ability to return to activities (21%), and neurologic injury (17%). Top 3 concerns for parents were pain (35%), neurologic injury (21%), and amount of correction (17%). Top 3 concerns for surgeons were postoperative shoulder balance (44%), neurologic injury (27%), and LIV selection (27%). Patients reported the same concerns 23% of the time as parents, and 17% of the time as surgeons. Parents and surgeons reported the same concerns 21% of the time.
CONCLUSIONS:
Pain was the greatest concern for both patients and parents but was rarely listed as a concern by surgeons. Parent and patient level of concern did not correlate to the surgeon’s assessment of the procedure’s complexity. Neurologic injury was a top concern for all groups, but otherwise there was little overlap between physician, patient and parent concerns.
LEVEL OF EVIDENCE: 3.
PMID: 28263228 DOI: 10.1097/BRS.0000000000002147
