Emory Report

December 13, 1999

 Volume 52, No. 15

Study says expectations play role in surgical outcomes

Patients who expect pain relief and improved functioning after surgery for low-back pain are more likely to have their expectations met than patients with less faith in their impending surgery, according to Emory neurosurgeon Gerald Rodts, citing preliminary results of the Spinal Surgery Consortium for Outcomes Research (SCORE) project.

"Most patients who undergo low-back surgery report improvements in pain and functional ability; however, patients who report higher levels of treatment expectations before surgery improve the most," said Rodts, an assistant professor of neurosurgery in the School of Medicine.

Emory neurosurgery researchers and SCORE collaborators at other institutions are seeking to improve the quality and cost effectiveness of spine surgery for low-back problems.

"First, we want to develop a method to measure the outcomes of each spine surgery for low-back problems and report that data back to the clinics involved in the SCORE consortium," said neurosurgeon Regis Haid, director of Neurosurgical Spine at The Emory Clinic. "The outcome measures we focus on include improvement in pain and function, days of work lost, cost of treatment and patient satisfaction.

"Secondly, the project is intended to help physicians predict the likelihood that a surgical candidate will experience a successful surgical treatment," Haid added. "Factors in addition to patient expectations that influence surgical outcome include age, intensity of pain and its effect on the ability to function."

Spine problems are the single most common reason for patient visits to the neurosurgery section at the clinic. Well aware of this trend and the potential for outcomes research to improve care, neurosurgery chair Daniel Barrow helped form the SCORE consortium. Other member institutions include the Cleveland Clinic Foundation, Mayo Clinic, Henry Ford Health System (Detroit), Lahey Clinic (Burlington, Mass.), and Lovelace Health System and University of New Mexico (Albuquerque). Emory neurosurgeon Scott Erwood is serving as Emory's SCORE representative.

At any given time, about 1 percent of the U.S. population is chronically disabled by low-back problems, and another 1 percent is temporarily disabled. Studies indicate that 80-85 percent of people experience low-back problems sometime during their lives. The cost of low-back problems to society is considerable, with estimates upwards of $50 billion annually.

More information on SCORE is available at www.emory.edu/WHSC/neurosurgery or at www.hfhs-cce.org/score.

-Lorri Preston

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