Outcome measures reflecting patient satisfaction following decompression surgery for lumbar spinal stenosis: Comparison of major outcome measures

Objective: Decompression surgery is the standard treatment for lumbar spinal stenosis (LSS); however, despite the good clinical outcomes reported for this procedure, a relatively high dissatisfaction rate has been reported. We hypothesized that the previously used outcome measures do not accurately reflect patient satisfaction (PS). This study aimed to examine which outcome measures reflect PS accurately in patients undergoing decompression for LSS.

Patients and methods: Patients with LSS treated with lumbar decompression surgery between January 2014 and March 2016 were enrolled if they had the preoperative and final follow-up questionnaires including the Numeric Rating Scale (NRS), Roland-Morris Disability Questionnaire (RMDQ), Japanese Orthopaedic Association Back Pain Evaluation Questionnaire (JOABPEQ), and Short Form-8 (SF-8). PS was evaluated using the question, "How satisfied are you with the overall result of your back operation?". There are four possible answers consisting of "very satisfied (4-point)", "somewhat satisfied (3-point)", "somewhat dissatisfied (2-point)", or "very dissatisfied (1-point)". The Spearman correlation coefficient between PS and each questionnaire was calculated.

Results: Postoperative JOABPEQ had strong correlation with PS (r > 0.6) whereas NRS, RMDQ and SF-8 had moderate correlation (0.4 <r < 0.6). JOABPEQ reflected PS much better than other questionnaires.

Conclusion: JOABPEQ reflected PS and therefore may be used as a main outcome measure in evaluating patients who underwent decompression surgery for LSS.