Immediate patient perceptions following lumbar spinal fusion surgery: semi-structured multi-centre interviews exploring the patient journey and experiences of lumbar fusion surgery (FuJourn)

September 18, 2022

doi: 10.1007/s00586-022-07381-x.

Online ahead of print.

Alison Rushton^{1

2}, Bini Elena³, Feroz Jadhakhan³, Annabel Masson³, J Bart Staal⁴, Martin L Verra⁵, Andrew Emms⁶, Michael Reddington⁷, Ashley Cole⁸, Paul C Willems⁹, Lorin Benneker¹⁰, Nicola R Heneghan³, Andrew Soundy¹¹

Affiliations

¹ School of Physical Therapy, Faculty of Health Sciences, Western University, London, ON, Canada. [email protected].
² Centre of Precision Rehabilitation for Spinal Pain, School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Edgbaston, Birmingham, UK. [email protected].
³ Centre of Precision Rehabilitation for Spinal Pain, School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Edgbaston, Birmingham, UK.
⁴ Radboud Institute for Health Sciences, IQ Healthcare, Radboud University Medical Centre, Nijmegen, The Netherlands.
⁵ Department of Physiotherapy, Bern University Hospital, Insel Group, Bern, Switzerland.
⁶ Department of Physiotherapy, The Royal Orthopaedic Hospital NHS Foundation Trust, Birmingham, UK.
⁷ Department of Physiotherapy, Sheffield Teaching Hospitals NHS Foundation Trust, Northern General Hospital, Sheffield, UK.
⁸ Department of Orthopaedics & Trauma, Sheffield Children’s Hospital NHS Foundation Trust, Sheffield, UK.
⁹ Maastricht University Medical Centre, Maastricht, The Netherlands.
¹⁰ Department of Orthopaedic Surgery Inselspital, University of Bern, Bern, Switzerland.
¹¹ School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Edgbaston, Birmingham, UK.

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Alison Rushton et al.

Eur Spine J.

2022.

doi: 10.1007/s00586-022-07381-x.

Online ahead of print.

Authors

Affiliations

¹ School of Physical Therapy, Faculty of Health Sciences, Western University, London, ON, Canada. [email protected].
² Centre of Precision Rehabilitation for Spinal Pain, School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Edgbaston, Birmingham, UK. [email protected].
³ Centre of Precision Rehabilitation for Spinal Pain, School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Edgbaston, Birmingham, UK.
⁴ Radboud Institute for Health Sciences, IQ Healthcare, Radboud University Medical Centre, Nijmegen, The Netherlands.
⁵ Department of Physiotherapy, Bern University Hospital, Insel Group, Bern, Switzerland.
⁶ Department of Physiotherapy, The Royal Orthopaedic Hospital NHS Foundation Trust, Birmingham, UK.
⁷ Department of Physiotherapy, Sheffield Teaching Hospitals NHS Foundation Trust, Northern General Hospital, Sheffield, UK.
⁸ Department of Orthopaedics & Trauma, Sheffield Children’s Hospital NHS Foundation Trust, Sheffield, UK.
⁹ Maastricht University Medical Centre, Maastricht, The Netherlands.
¹⁰ Department of Orthopaedic Surgery Inselspital, University of Bern, Bern, Switzerland.
¹¹ School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Edgbaston, Birmingham, UK.

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Abstract

Purpose:

To understand the patient journey to Lumbar Spinal Fusion Surgery (LSFS) and patients’ experiences of surgery.

Methods:

Qualitative study using interpretive phenomenological analysis. Adult participants following LSFS were recruited from 4 UK clinical sites using purposive sampling to ensure representation of key features (e.g. age). Semi-structured interviews informed by a piloted topic guide developed from the literature were audio-recorded and transcribed verbatim. Framework analysis for individual interviews and then across participants (deductive and inductive) identified emerging themes. Trustworthiness of data analyses was enhanced using multiple strategies (e.g. attention to negative cases).

Results:

Four emerging themes from n = 31 patients’ narratives were identified: decision for surgery, coping strategies, barriers to recovery and recovery after surgery. Decision for surgery and recovery after surgery themes are distinguished by the point of surgery. However, barriers to recovery and coping strategies are key to the whole patient journey encompassing long journeys to surgery and their initial journey after surgery. The themes of coping strategies and barriers to recovery were inter-related and perceived by participants as parallel concepts. The 4 multifactorial themes interacted with each other and shaped the process of an individual patient’s recovery. Factors such as sporadic interventions prior to surgery, time-consuming wait for diagnosis and surgery and lack of information regarding recovery strongly influenced perceptions of outcome.

Conclusion:

Patient driven data enables insights to inform research regarding surgery/rehabilitation through depth of understanding of the patient journey. Awareness of factors important to patients is important; ensuring that patient-driven data informs research and patient care.

Keywords:

Interpretive phenomenological analysis; Interviews; Lived experience; Lumbar spinal fusion surgery; Patient journey; Recovery.

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