Informed Spinal Stenosis and Herniated Disc Patients are More Satisfied and Have Less Pain and Disability


The International Society for the Study of the Lumbar Spine (ISSLS) is a group of 250 members from around the world who are experts in the study and treatment of lumbar spine disorders. In 2017, their annual meeting was held in Athens, Greece where over 300 presentations.

Steven Atlas, MD and colleagues from the Massachusetts General Hospital presented the results of a clinical trial designed to evaluated the impact of shared decision making on patient satisfaction associated with spine surgery for lumbar herniated disc and lumbar spinal stenosis. Shared decision making involves informing patients about treatment options and their respective risks and benefits.

The doctors designed a survey to test whether individuals who were informed and received their choice of therapy would be more satisfied and have less regret. In the study over 200 patients were initially surveyed one week after their initial consultation with regard to their knowledge, preferred treatment (surgical or non-surgical) quality of life, and current level of disability. A follow-up survey was the completed 6 months later or 3 months after surgery assessing treatment, quality of life, satisfaction or regret.

Overall 82% of enrolled patients completed surveys, and individuals who had a passing knowledge score of 40%, and received their preferred therapy were considered to have made an informed patient centered decision.

The study found that informed patients had significantly better overall outcomes and quality of life. Informed patients experienced greater pain relief, and overall were more satisfied with treatment.

The authors suggest that an informed patient is a more satisfied patient with less pain and disability. Shared decision making contributes to a better overall understanding of treatment and its expectations, which can benefit both the patient and their physician.


Atlas SJ, Chang Y, Cha TD et al. Shared decision making in orthopedic spine care leads to better health outcomes: A prospective cohort study. Abstract 34 44th ISSLS meeting

David Borenstein, M.D.

Executive editor TheSpineCommunity


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