Back Surgery Doesn't Live up to Expectations
Reported June 21, 2005

(Ivanhoe Newswire) -- Surgeons may be leading some back surgery patients down a primrose path, find researchers who compared surgeons' predictions of success with actual patient outcomes.

Results show 99 percent of doctors believed surgery would provide at least moderate improvement for people with low back pain or sciatica. One year later, 39 percent of patients reported no "minimally clinically important" difference in their conditions due to the surgery.

Among the 79 percent of patients for whom doctors predicted the surgery would result in "a great deal of improvement" in their quality of life, 56 percent said the surgery led to no significant improvements in their overall health one year later.

Interestingly, the only group of patients that did appear to benefit from the surgery were those who didn't meet standard criteria for the operations in the first place. The investigators believe a "curabo effect" may be at play in these cases. Specifically, patients whose doctors really believed they should have the surgery despite lack of medically sound criteria might simply be working harder with these patients to achieve the desired outcome.

The authors write, "Physician expectation may have by itself an influence on patient outcomes."

The study involved 197 patients and was conducted in Switzerland.

SOURCE: Spine, published online June 15, 2005