Electronic Thesis and Dissertation Repository

Thesis Format

Integrated Article

Degree

Master of Science

Program

Health and Rehabilitation Sciences

Supervisor

Battié, Michele C.

Abstract

Introduction: Lumbar spinal stenosis (LSS) is a degenerative condition among older adults associated with narrowing of the spinal canal. Spine surgery is considered an elective procedure.

Study Aim: The aim of this study was to examine patient-related factors that may affect surgical treatment decision-making for LSS.

Methods: Data from the Alberta Lumbar Spinal Stenosis Study were used to investigate the association between baseline factors and spine surgery within two years. Possible predictors were examined in crude and multivariable analyses

Results: In univariate analyses the Oswestry Disability Index, Health Utilities Index, Swiss Spinal Stenosis physical function and symptom severity subscales, and patients’ beliefs and perceptions were associated with the decision to undergo surgery. In multivariable analysis only beliefs about benefits of spine surgery and dissatisfaction living with symptoms were significant.

Conclusion: Patients’ beliefs and perceptions are more important in their surgical decision-making than other factors like disability, sex and age.

Summary for Lay Audience

Lumbar spinal stenosis (LSS) is a common condition in older adults associated with a narrowing of the spinal canal in the lower back. This narrowing can cause pressure on the spinal cord, blood vessels and nerves that exit the spinal canal to go to the rest of the body (muscles, organs, etc.). LSS can be treated conservatively (without surgical intervention) or with surgery. We were interested in finding out what factors influence patients’ decision to undergo surgery. We were particularly interested in patients’ beliefs about the benefits and risks of having back surgery, their satisfaction with prior care, and their level of satisfaction with continuing life with current symptoms. We found that patients that have high levels of disability, more severe symptoms, lower health related quality of life, less satisfaction with symptoms, less satisfaction with the care they previously received, and higher expectations for surgical benefits tend to choose surgery more than the others. But the most important factors among these were patients’ perceived benefits of surgery and their level of dissatisfaction with continuing life with current symptoms.

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