Decompression surgery for lumbar spinal stenosis in the elderly: Preoperative expectations and postoperative satisfaction

Study design: Retrospective cohort examination. Objectives: Data on expectations and satisfaction rates in elderly patients operated for lumbar spinal stenosis (LSS) are limited. The present study aimed to investigate these issues as well as the factors that might affect them. Setting: A university affiliated hospital. Patients and methods: A follow-up study of 367 consecutive patients aged 65 years and older (mean age 71.4 years), who underwent surgery for degenerative LSS between 1990 and 2000. Data collection included patients' preoperative expectation, demographic data, body mass index, operative risk, duration of symptoms, clinical presentation and patients' satisfaction on follow-up, pain level, activities of daily living level and walking ability. Data were recorded before operation and on follow-up. Preoperative and follow-up data were analyzed by univariate and multivariable models. Results: The response rate on follow-up was 81% (298 patients). A logistic regression analysis showed that advanced age, male gender and high education level were independently associated with positive expectations, while a great number of covariates were associated with patients' satisfaction. High patients' expectations were positively interrelated with satisfaction (r=0.332, P<0.001). Conclusions: In the elderly, preoperative expectations reasonably predict their postoperative satisfaction rate. It is suggested that a greater effort should be made to narrow the gaps between expectations and satisfaction, perhaps by providing more accurate preoperative information data regarding the outcomes of planned surgery.