1. Copyright © 2014 Lippincott Williams & Wilkins. Unauthorized commercial reproduction of this slide is prohibited Supplemental PowerPoint Slides Patients’ Expectations of Cervical Spine Surgery Carol A. Mancuso MD Hospital for Special Surgery, NY Weill Cornell Medical College, NY Roland Duculan MD Hospital for Special Surgery, NY Marina Stal MA Hospital for Special Surgery, NY Federico P. Girardi MD Hospital for Special Surgery, NY

2. Patients’ Expectations of Cervical Spine Surgery The goals of this cross-sectional study were to preoperatively describe patients’ long-term expectations of cervical spine surgery in terms of demographic, clinical, and psychological characteristics. Expectations were measured several days before surgery with a 20-item valid standardized questionnaire that addresses symptoms, psychological well-being, and anticipated future spine condition. An overall score is calculated based on the number of items expected and the amount of improvement expected. Patients also completed several other valid questionnaires measuring disability due to neck pain and overall physical and mental function. Multivariate analyses were conducted with expectations as the dependent variable and demographic, clinical, and psychological characteristics as independent variables.

3. Results and Implications 150 patients were enrolled, mean age was 54 years, 61% were men, most common diagnoses were radiculopathy (67%) and myelopathy (27%). Most commonly chosen expectations were relieve neck pain (87%), relief upper extremity pain (85%), stop the spine condition from getting worse (97%), and remove the control the spine condition has on life (96%). In multivariate analysis, patients had greater expectations if they were younger (OR 2.2, CI 1.2-4.0, p=.01), had more neck disability (OR 6.5, CI 3.2-13.2, p<.0001), and had worse overall physical (OR 1.9, 1.0-3.6, p=.05) and mental function (OR 2.0, 1.1-3.6, p=.02). Measuring expectations should be part of the comprehensive preoperative assessment of patients. Knowing what patients expect helps direct patient education, fosters shared-decision making, and provides a means for patients and surgeons to set concordant goals.