P122. Meeting preoperative expectations for pain predicts patient satisfaction following ACDF

Abstract

<h3>BACKGROUND CONTEXT</h3> Previous studies have examined factors that determine patient satisfaction following anterior cervical discectomy and fusion (ACDF). However, few have explored the influence of meeting preoperative expectations on postoperative satisfaction. <h3>PURPOSE</h3> To assess the predictive value of meeting preoperative expectations for patient satisfaction following ACDF. <h3>STUDY DESIGN/SETTING</h3> Retrospective Cohort. <h3>PATIENT SAMPLE</h3> A total of 34 patients undergoing primary ACDF procedures. <h3>OUTCOME MEASURES</h3> Demographic and perioperative characteristics, Visual Analog Scale (VAS) neck and arm. <h3>METHODS</h3> A prospectively maintained surgical registry was retrospectively reviewed for ACDF procedures from 2016 to 2019. Patients' expectations regarding surgical outcomes in neck and arm pain were assessed preoperatively using the questions, "What do you expect your [arm/neck] pain to be following surgery?" Current levels of pain were assessed using the Visual Analogue Scale (VAS) at preoperative and 6-week, 12-week, 6-month and 1-year postoperative timepoints, while patients' satisfaction with their current level of pain was assessed on a scale of 1-10 at each postoperative timepoint. Whether expectations were met was evaluated by comparison of expectation scores to actual postoperative VAS scores. Linear regression assessed pain improvement and meeting expectations as predictors of satisfaction scores at each timepoint. <h3>RESULTS</h3> The study cohort consisted of 34 patients undergoing primary ACDF procedures. By 1-year postoperatively, 85.3% and 82.4% of patients had met their expectations for neck and arm pain, respectively. Improvement in pain was a significant predictor of satisfaction only for neck pain at 6-months (p=0.001) and arm pain at 12-weeks (p=0.014) and 6-months (p=0.001). Meeting preoperative expectations was a significant predictor of satisfaction at all timepoints (all p<0.05), except for neck pain at 6-weeks (p=0.327). <h3>CONCLUSIONS</h3> Most patients achieved their preoperative expectations for neck and arm pain by 1-year following ACDF. While overall improvement in pain only predicted postoperative satisfaction at a few timepoints, meeting preoperative expectations for postoperative pain significantly predicted patient satisfaction at all timepoints except 6-weeks. Therefore, patients' preoperative expectations may actually be a more important indicator for postoperative success than their raw improvement in pain scores. <h3>FDA DEVICE/DRUG STATUS</h3> This abstract does not discuss or include any applicable devices or drugs.