Decisional Regret Following Corrective Adult Spinal Deformity Surgery: a Single Institution Study of Incidence and Risk Factors

Overview

Journal Spine Deform

Publisher Springer Nature

Date 2024 Jan 30

PMID 38289505

Authors

Jerry Y Du

Francis C Lovecchio

Gregory Kazarian

John Clohisy

Anthony Pajak

Austin Kaidi

Rachel Knopp

Izzet Akosman

Mitchell Johnson

Hiroyuki Nakarai

Alexander Dash

Justin T Samuel

Matthew E Cunningham

Han Jo Kim

Affiliations

Soon will be listed here.

Abstract

Purpose: To assess the characteristics and risk factors for decisional regret following corrective adult spinal deformity (ASD) surgery at our hospital.

Methods: This is a retrospective cohort study of a single-surgeon ASD database. Adult patients (> 40 years) who underwent ASD surgery from May 2016 to December 2020 with minimum 2-year follow-up were included (posterior-only, ≥ 4 levels fused to the pelvis) (n = 120). Ottawa decision regret questionnaires, a validated and reliable 5-item Likert scale, were sent to patients postoperatively. Regret scores were defined as (1) low regret: 0-39 (2) medium to high regret: 40-100. Risk factors for medium or high decisional regret were identified using multivariate models.

Results: Ninety patients were successfully contacted and 77 patients consented to participate. Nonparticipants were older, had a higher incidence of anxiety, and higher ASA class. There were 7 patients that reported medium or high decisional regret (9%). Ninety percentage of patients believed that surgery was the right decision, 86% believed that surgery was a wise choice, and 87% would do it again. 8% of patients regretted the surgery and 14% believed that surgery did them harm. 88% of patients felt better after surgery. On multivariate analysis, revision fusion surgery was independently associated with an increased risk of medium or high decisional regret (adjusted odds ratio: 6.000, 95% confidence interval: 1.074-33.534, p = 0.041).

Conclusions: At our institution, we found a 9% incidence of decisional regret. Revision fusion was associated with increased decisional regret. Estimates for decisional regret should be based on single-institution experiences given differences in patient populations.

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