A survey of patients attitude toward low back surgery in a major center in Saudi Arabia

OBJECTIVE: Similar to any other invasive procedure, low back surgery has potential complications. These potential complications lead many patients to refuse the surgery when it is indicated. The aim of this study was to evaluate patient's attitude toward low back surgery and identify factors that might influence their decision.

METHODS: Seventy consecutive patients who attended the outpatient clinic of the King Fahad National Guard Hospital Riyadh, Kingdom of Saudi Arabia, between May 2002 and July 2002, due to chronic low back problems and who were surgical candidates were included in this study. The low back outcome score (LBOS) was used to assess these patients. The proposed surgical procedure was explained to each patient and the family and the potential complications were discussed. The patient's response to the proposed surgery was assessed. Mantel-Haeuszel Chi-square test was used for statistical analysis.

RESULTS: A total of 70 patients were included in this study. Thirty-eight were females and 32 were males. The average duration of symptoms was 3.3 years (range 0.5-20). Of the whole group of 70 patients, 31 (44%) agreed to surgery. The remaining 39 (56%) refused surgery for various reasons. There was no statistically significant difference in the demographic data or the LBOS between the 2 groups.

CONCLUSION: There is a relatively high refusal rate (56%) for low back surgery in the group studied. No specific influencing factor could be identified in this group. Pain and disability as measured by the LBOS does not seem to be a factor. Patient's education on the disease process and the contemplated surgery are crucial in helping them to make an informed and reasonable decision.