Patient satisfaction with follow-up after spinal fusion

Alexander O Akoto; Bilal B Butt; Aditya Muralidharan; Eric Olsen; Muhammad Abdul-Aziz Waheed; Rakesh Patel; Ilyas Aleem

doi:10.21037/jss-23-4

Patient satisfaction with follow-up after spinal fusion

J Spine Surg. 2023 Jun 30;9(2):123-132. doi: 10.21037/jss-23-4. Epub 2023 May 23.

Authors

Alexander O Akoto¹, Bilal B Butt¹, Aditya Muralidharan¹, Eric Olsen¹, Muhammad Abdul-Aziz Waheed¹, Rakesh Patel¹, Ilyas Aleem¹

Affiliation

¹ Department of Orthopaedic Surgery, University of Michigan, Ann Arbor, MI, USA.

Abstract

Background: Postoperative follow-up visits (PFUs) allow providers to track patient recovery but can be costly to patients. With the advent of the novel coronavirus pandemic, virtual/phone visits have been utilized as an alternative to in-person PFUs. Patients were surveyed to elucidate patient satisfaction with postoperative care in the setting of increased virtual follow-up visits. A prospective survey with retrospective cohort analysis of chart data was conducted to better understand the factors influencing patient satisfaction related to their PFUs after spine fusion with the goal of improving the value of postoperative care.

Methods: Adult patients at least 1 year postoperative from cervical or lumbar fusion surgery completed a telephone survey related to their postoperative clinic experience. Medical record data including complications, number of visits and length of follow-up, and presence of phone/virtual visits were abstracted and analyzed.

Results: Fifty patients (54% female) were included. Univariate analysis demonstrated no association between satisfaction and patient demographics, rates of complication, mean length or number of PFUs, or incidence of phone/virtual visits. Patients "very satisfied" with their clinic experience were more likely to be "very satisfied" with their outcome (P<0.01), and to feel their concerns were "very well addressed" (P<0.01). Multivariate analysis additionally demonstrated that satisfaction was positively associated with how well patient concerns were addressed (P<0.01) and the incidence of virtual/phone visits (P=0.01), and negatively associated with age (P=0.01) and level of education (P=0.01).

Conclusions: After spinal fusion, patient satisfaction is positively related to virtual/phone visits and to how well their concerns are addressed. As long as patient concerns remain adequately addressed, surgeons can eliminate excess PFUs which are not clinically beneficial without adversely impacting patients' postoperative experience.

Keywords: Follow-up; postoperative; satisfaction; spinal fusion; spine surgery.