Patient satisfaction following minimally-invasive and open surgery for adult spinal deformity.

Abstract

OBJECTIVE\nPatient satisfaction has become an important variable in assessing outcomes after spine surgery. While minimally-invasive surgery (MIS) techniques have become popular due to reduction in perioperative complications over open deformity surgery, it is unclear if patient reported postoperative satisfaction differ between the two surgical approaches. The aim of this study was to characterize postoperative PRO in patients who underwent open or MIS deformity surgery.\n\n\nMETHODS\nPRO scores were prospectively collected for patients undergoing deformity correction surgery between 2016-2018. Inclusion criteria were age>18, adult spinal deformity(ASD), and completed PRO surveys. Patient demographics, clinical, radiographic data, and PRO were analyzed. Post-hoc analysis comparing patients who were satisfied versus unsatisfied was performed.\n\n\nRESULTS\nForty patients underwent operative management of ASD(19 open vs. 21 MIS) who met the inclusion criteria. Patients who underwent MIS surgery reported higher mental health and self-image scores at 6 months. However, at 12-month follow-up, both the open and MIS groups achieved minimal clinically important difference in back pain, leg pain, and functional status. Patient satisfaction scores did not differ based on surgical approach or intraoperative complications.\n\n\nCONCLUSION\nPRO after open and MIS deformity surgery reflected successful outcomes with significant improvements in PRO survey scores but with subtle differences in their postoperative recovery process. The MIS group reported faster recovery experience with earlier improvement in self-image and mental-health scores which may stem from requiring smaller deformity correction. At 12-month follow-up, postoperative satisfaction was high for the majority of the patients.