Preoperative spinal education for lumbar spinal stenosis (POSE-LSS): A qualitative analysis of patient experiences.

Abstract

Surgical intervention for lumbar spinal stenosis (LSS) is common and associated with high rates of postoperative side effects or complications. Prehabilitation programs aim to reduce postoperative complications and enhance outcomes. However, the clinical effectiveness of prehabilitation programs for patients undergoing LSS surgery has yet to be fully investigated. A key part of this investigation is to gain insight into how to design these programs through an iterative process that includes feedback from patients' experiences. To explore patients' experiences with a novel prehabilitation program: Pre-Operative Spinal Education for Lumbar Spinal Stenosis (POSE-LSS). Individual structured telephone interviews with pragmatic qualitative analysis. Academic medical center. Patients (n = 10) who underwent lumbar spinal stenosis surgery and completed the POSE-LSS program prior to their surgery were included (six women; four men, mean age: 62.3 years). POSE-LSS is a novel multimodal, education-focused, time-efficient prehabilitation program for patients undergoing LSS surgery. Participants received the following: (1) educational booklet and video, (2) in-person physical therapy (PT) session, and (3) telemedicine visit with a physiatrist. One-on-one structured interviews to understand patients' experiences with a LSS prehabilitation program. Participants in this qualitative study described a favorable, unique, and feasible experience associated with participation in the POSE-LSS program. Three main themes were developed from these interviews about POSE-LSS: (1) it helped patients to better prepare for their surgery and improved postoperative expectations, (2) it addressed modifiable psychological factors associated with the surgical intervention, and (3) it fits into a larger support system necessary to meet patients' needs. The perspectives gained from this qualitative study can inform improved design and evaluation of LSS prehabilitation programs.