Lightning Podiums: Value and Outcomes in Spinal Surgery - Room 801B

Presented by: X. Hu


X. Hu(1), A. Block(2), S. Bederman(3), I. Lieberman(1)

(1) Texas Back Institute, Texas Health Presbyterian Hospital Plano, Scoliosis and Spine Tumor Center, Plano, TX, United States
(2) Texas Back Institute, Plano, TX, United States
(3) Restore Orthopedics & Spine Center, Orange, CA, United States


Introduction: Patient activation is defined as an individual's propensity to engage in adaptive health and rehabilitation behaviors. It is a potentially important factor contributing to the variations in postsurgical outcome. However, little is known about the factors that affect activation in patients with spine disorders. The purpose of this study is to prospectively evaluate the relationship between pain and patient activation in a series of individuals undergoing spine surgery.

Methods: Adult patients who were scheduled to have spine surgery with two surgeons were consented and prospectively enrolled in the study. Pre-operatively, the Visual Analogue Scale (VAS) was used to assess the patients' back pain and leg pain levels. The Patient Activation Measure (PAM) was used to assess the patients' activation level (higher score = higher level = better activation). The patients were classified into two groups based on their PAM scores: low activation (level 1-3) and high activation (level 4). The patients' demographics and pre-operative diagnosis were also recorded.

Results: A total of 56 patients were enrolled in the study. The patients' mean age was 61 years (range 20-83) and 39 patients (69.6%) were female. The patients' primary diagnoses were scoliosis, stenosis and spondylolisthesis. The patients' mean back pain was 6.7 points and their mean leg pain was 4.6 points. Patients with low activation had significantly higher back pain scores (7.7 vs 6.1 points, p< 0.02). Meanwhile, there is no correlation between leg pain scores and patient activation level (4.1 vs 4.9 points, p>0.05).

Conclusion: Our data shows that there is a negative correlation between back pain and patient activation in individuals undergoing spine surgery. Further study is underway to examine if optimizing the activation level in these patients can improve the surgical outcome.