Finding Surgical Success
Driving a car to the local mechanic to get it fixed is not the same thing as taking the human body into surgery; although, this “fix-it” attitude drives patients and surgeons alike towards surgical solutions. Lately, a growing number of people are undergoing low back surgery. A recent study examined the relationship between patient expectations and the actual outcomes from lumbar spine surgery. Because pre-surgical expectations do not always equate to the actual results, how can a person judge whether or not a surgery was successful? How can one predict surgical success?
Understanding the primary reasons for seeking surgical solutions is the first step towards discussing the likelihood of success. The top three causes for patients wanting lumbar surgery are: 1#, other therapies have failed to help; 2#, the pain is unbearable; 3#, walking has become difficult. Based on these reasons to see a surgeon, patients come to the operating room harboring certain expectations. Patients want the pain intensity to reduce in the limbs and spine. Patients also want an improved ability to walk comfortably. Patients, family members, and healthcare providers need to be aware of these expectations and discuss them thoroughly.
Of upmost importance, this discussion needs to include the probability that the pre-surgical expectations may not equal the actual outcome. Obviously if the expectations are met or exceeded by the surgical outcomes, the surgery would be deemed a smashing success. But, what happens if the results fall short of the hopes for having substantially less pain and much improved walking abilities? That really depends on the patient’s attitude going into the surgery. According to researchers, those who went into surgery with an optimistic attitude are protected from disappointment compared with those who have a pessimistic attitude prior to surgery. In fact, optimists reported a better quality of life three months after surgery compared to pessimists. Following this line of thought, predicting surgical “success” may be a matter of optimism versus pessimism and not based solely on the actual results. The implications of this research are two-fold. Surgeons may want to steer clear of pessimistic surgical candidates who are unlikely to be satisfied. And patients may want to learn to be optimistic prior to surgery. This same strategy has already proven itself in the political arena.
In political races, the public usually steers clear of the pessimistic candidate according to extensive research by Dr. Martin Seligman, past President of the American Psychological Association and author of “Learned Optimism”. Therefore, the politicians have learned to be optimistic and deliver an optimistic message of hope in order to win. Surgeons and patients can learn from this winning strategy to insure surgical success. Optimism is a pathway to success.
Stay tuned for ways to become more optimistic.
Christina Lasich, M.D., wrote about chronic pain and osteoarthritis for HealthCentral. She is physiatrist in Grass Valley, California. She specializes in pain management and spine rehabilitation.