The concerns and experiences of patients with lumbar spinal stenosis regarding prehabilitation and recovery after spine surgery: A qualitative study

Objectives To improve our understanding of patients’ perspectives regarding: (1) the decision making and prehabilitation before lumbar spinal stenosis (LSS) surgery; and (2) their postoperative experiences. Design Qualitative research with semi-structured interviews. Setting General community Participants Individuals received (n=10) and did not receive (n=15) prehabilitation before LSS surgery were recruited at the 6-month postoperative follow-up (8 females; average age: 67.7±6.7 years) by purposive sampling. Additionally, one participant invited her daughter to accompany her in an interview. Interventions Not applicable Main outcome measures Concerns and experiences of patients with LSS regarding prehabilitation and recovery after spine surgery. Results Thematic analysis was conducted to identify four themes inductively: (1) sources of information about LSS surgery; (2) factors affecting the surgical decision making; (3) attitudes toward prehabilitation; and (4) postoperative recovery. All participants desired to have more preoperative education to inform their surgical decision making. There were mixed opinions regarding the perceived benefits of prehabilitation because some individuals hesitated to participate in prehabilitaiotn due to their symptoms, or the cost or time of travelling. Many participants expected some or even complete relief of LSS-related symptoms after surgery. However, not all participants experienced the expected postoperative improvements. Some participants only experienced temporary symptomatic relief, while others experienced new postoperative symptoms. Patients generally found that postoperative exercises taught by physiotherapists were useful although their compliance decreased over time. Conclusions Our study highlights the need for better preoperative LSS education. Since face-to-face prehabilitation or postoperative rehabilitation may not be feasible for all patients, future studies should explore whether online-based prehabilitation o