PATIENT EXPECTATIONS AND FUNCTIONAL OUTCOME FOLLOWING POSTERIOR LUMBAR SURGERY
Bibliographic record
Abstract
There is increasing knowledge regarding the functional outcome of patients following posterior lumbar spinal surgery for degenerative conditions of the spine. There is less known regarding the expectations patients have for spinal surgery and how that may relate to commonly reported surgical outcome measures. It was the purpose of this study to evaluate the results of elective lumbar spinal surgery as it relates to patient expectations for outcome. and outcome as quantified by both physician reported outcome and patient derived generic and disease-specific measures. Patient expectations for surgery were evaluated in one hundred and fifty-five consecutive patients undergoing posterior lumbar surgery for degenerative conditions (single institution, two surgeons). SF-36+Oswestry disability was quantified preoperatively, and serially postoperatively. Preoperative expectations (pain relief, sleep, recreational, ADL, work return) were documented and postoperative expectations quantified at time of anticipated maximal medical improvement (6mos decompressions,1yr with fusions). Mean preoperative SF-36 MCS and PCS scores were 3.4 and 1.2 S.D. below age/gender matched Canadian norms. Although patients reported improvements in SF-36+Oswestry scores following surgery, mean SF-36 MCS and PCS scores were still 2 and 1.5 S.D. below norms. Mean Oswestry disability improved from 48.7%±1.7% to 23.1±1.9%. Expectations for surgery were met in 81%(responders:143/155). Of 19%(27/143) where expectations were not met, 6/27 have either nonunion, technical, or medical factors. There was no difference in mean age, gender, comorbidity, procedure type and follow-up comparing patients where expectations were met to those that were not. Patients where expectations were not met reported lower preoperative SF-36 (GH and VT) domain scores (p=0.02 and 0.04, respectively), however, preoperative Oswestry, SF-36 MCS and PCS scores were not significantly different. Patients were less satisfied if they had prior lumbar surgery (p=0.02) or involved in WCB/litigation (p We note 15%(21/143) where expectations were not met and there were no apparent surgical or medical confounds to account. There are likely other factors that may influence patient perception and expectation for treatment which requires further study.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.009 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".