VANTI CARLA (Department of Biomedical and Neuromotor Sciences (DIBINEM), University of Bologna, Bologna 40138, Italy)
FERRARI SILVANO (Department of Biomedical and Neuromotor Sciences (DIBINEM), University of Bologna, Bologna 40138, Italy)
ALBANO ANGELA (Azienda Ospedaliero Universitaria IRCSS Sant’Orsola-Malpighi, Bologna 40138, Italy)
BURBELLO ILARIA (Physiotherapy Private Practice, 35019 Tombolo (PD), Italy)
DE CRISTOFARO LAURA (Department of Clinical Experimental Sciences, University of Brescia Brescia 25123, Italy)
MATTAROZZI KATIA (Department of Medical and Surgical Sciences (DIMEC), University of Bologna, Bologna 40138, Italy)
GASBARRINI ALESSANDRO (Department of Spine Surgery, IRCCS Istituto Ortopedico Rizzoli, Bologna 40136, Italy)
PILLASTRINI PAOLO (Department of Biomedical and Neuromotor Sciences (DIBINEM), University of Bologna, Bologna 40138, Italy)
Degenerative disorders of the spine are a widespread and disabling condition with significant clinical and socioeconomic impact (1) and spinal arthrodesis is a surgical option in the most severely affected patients (2). Although health-related quality of life (HRQoL) seems to improve after surgical treatment (3), patients candidates for lumbar surgery exhibit worse HRQoL compared to others with different orthopedic conditions (4). Although patient’s subjective experience following surgery has been investigated in several qualitative studies (5-6), no qualitative study has yet investigated the subjective perception of quality of life, expectations, emotional state, and fears of patients who are candidates for spinal surgery during the waiting period. Thus, the aim of this study is to understand cognition, emotional-behavioral state and quality of life of patients during time spent on the waitlist for lumbar spinal arthrodesis.
This qualitative study of semi-structured interviews was conducted at an orthopedic research institute in Italy. 15 patients participated in this study and were interviewed between May 2022 and February 2024. All patients signed a written informed consent to participate in the study. The interviews were transcribed and analyzed by a multiprofessional team (physiotherapists, orthopedic surgeon, psychologist) through thematic analysis. The study was approved by the Ethical Committee of Istituto Ortopedico Rizzoli on 24/03/2022, Prot. n. 0005021. The study protocol was registered on ClinicalTrials.gov database on 14/03/2022 with ID number NCT06323694.
Five main themes were found. (1) Pain and surgery: impact on quality of life, (2) Worries and fears during the waiting list time, (3) Expectations and hopes during the waiting list time, (4) Issues with the waiting list time, (5) Need for better communication and information on the care pathway. Three secondary themes were also produced: (6) social and family support during the course of treatment, (7) interpersonal relationships and social estrangement and (8) coping strategies.
The findings of the study highlight that patients on the waiting list for spinal arthrodesis need more certainty about waiting times, better communication with hospital staff, more thorough information about their care pathway. This could help patients feel more confident and may lead to more adequate expectations before surgery.
