Quality Reports

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• ABOUT OUR PATIENTS
  
  Learn more about patients who participated in SPORT more... at the Spine Center at DHMC. This information was collected before treatment when patients signed up for the study. Patients were randomly put into one of two treatment groups. One group was treated surgically. The other group got non-operative treatment.
  • Patients with Spinal Stenosis
    • Number of patients

      Surgical		Non-operative
      45		23

    • Average age (in years)

      64.5

      67.7

    • Percent of patients who are female

      31%

      43%

    • Percent of patients who have at least some college education

      49%

      61%

  • Work status
    • Percent of patients who work full or part time

      Surgical		Non-operative
      31%		17%

    • Percent of patients who are disabled

      11%

      17%

    • Percent of patients who are retired

      47%

      57%

    • Percent of patients who do not work for other reasons (other than being disabled or retired)

      11%

      9%

    • Percent of patients who are on Worker's Compensation

      11%

      9%

  • Comorbidities
    • Percent of patients who have hypertension

      Surgical		Non-operative
      24%		57%

    • Percent of patients who have diabetes

      18%

      22%

    • Percent of patients who have osteoperosis

      4%

      13%

    • Percent of patients who have a heart problem

      18%

      22%

    • Percent of patients who have a stomach problem

      7%

      17%

    • Percent of patients who have a bowel or intestinal problem

      11%

      13%

    • Percent of patients who have a diagnosis of depression

      9%

      14%

    • Percent of patients who have a joint problem (such as knee or hip pain)

      44%

      61%

    • Percent of patients who have some other medical condition (such as cancer or a history of stroke)

      22%

      39%

  • How long patients have had spinal stenosis symptoms
    • Percent of patients who have symptoms for more than 6 months

      Surgical		Non-operative
      67%		61%

  • Clinical findings
    • Percent of patients who have any neurological deficit

      Surgical		Non-operative
      58%		57%

    • Percent of patients with numbness

      29%

      17%

    • Percent of patients with weakness

      18%

      22%

  • Level of Stenosis
    • L2-L3

      Surgical		Non-operative
      22%		35%

    • L3-L4

      64%

      61%

    • L4-L5

      84%

      87%

    • L5-S1

      27%

      26%

• SURGICAL TREATMENTS AND EVENTS
  
  Learn more about surgery for SPORT patients with spinal stenosis more... at DHMC. This section has information about the kind of surgery performed, the hospital stay, and complications of surgery.
  • Type of surgery
    • Decompression only

      % of Surgery Patients

      96%

    • Non-instrumented fusion

      4%

    • Instrumented fusion

      0%

    • Multi-level fusion

      4%

  • Number of levels decompressed
    • 1

      % of Surgery Patients

      47%

    • 2

      20%

    • 3+

      33%

  • Surgery and hospital stay
    • Average length of operation (hours:minutes)

      2:16

    • Average amount of blood loss (cc)

      433

    • Average length of hospital stay (days)

      2.2

  • Mortality
    • Post-operative mortality (death within 3 months of surgery)

      % of Surgery Patients

      2%

  • Complications during surgery
    • Dural tear/spinal fluid leak

      % of Surgery Patients

      16%

    • Other

      2%

    • None

      82%

  • Post-operative complications/events
    • Wound Infection

      % of Surgery Patients

      4%

    • Other

      2%

    • None

      93%

  • Additional surgery (cumulative)*
    • Additional surgeries within 1 year

      % of Surgery Patients

      2%

    • Additional surgeries within 2 years

      7%

    • * Additional surgery (total of 3 cases) include new disc herniation and stenosis
• TREATMENT OUTCOMES
  
  Learn about how SPORT patients with spinal stenosis did over time more... at DHMC. This section shows how patients did after their surgical or non-operative treatment. The information was gathered with surveys that patients filled out at their Spine Center appointments.
  • Bodily Pain
    • This chart shows the Bodily Pain Score, which measures how much pain the patient has and how much it interferes with activities. A higher bodily pain score means that a patient has less pain.

      We get the results from the questionnaires filled out by the participants in SPORT who have spinal stenosis.

      The Bodily Pain score is from a survey called the SF-36. The SF-36 is a standardized way to look at how people are feeling mentally and physically.

      This chart shows:
      - These results are raw scores, not percentages; a higher score is better.
      - After treatment, the surgical patients had higher scores than the patients who had non-operative treatment.

  • Physical Function
    • This chart shows the Physical Functioning Score, which measures how the patient does on various activities, such as walking, bending and lifting.

      We get the results from the questionnaires filled out by the participants in SPORT who have spinal stenosis.

      The physical function score is from a survey called the SF-36. The SF-36 is a standardized way to look at how people are feeling mentally and physically.

      This chart shows:
      - These results are raw scores, not percentages; a higher score is better.
      - After treatment, the surgical patients had higher scores than the patients who had non-operative treatment.

  • Disability Index
    • This chart shows the Disability Score, which measures how much disability the patient has. The score measures disability from spine conditions on pain, personal care, lifting, walking, driving, and recreation.

      We get the results from the questionnaires filled out by the participants in SPORT who have spinal stenosis.

      The questions are from a survey called the Oswestry Disability Index (ODI). The ODI is a condition-specific survey for patients who have spine problems.

      This chart shows:
      - These results are raw scores, not percentages; a lower score is better.
      - After treatment, the surgical patients had lower scores than the patients who had non-operative treatment.

  • Stenosis Bothersomeness
    • This chart shows the Stenosis Bothersomeness, which measures how much the patient is bothered by pain, numbness tingling and burning in the low back, groin, leg, and foot.

      We get the results from the questionnaires filled out by the participants in SPORT who have spinal stenosis.

      This chart shows:
      - These results are raw scores, not percentages; a lower score is better.
      - After treatment, the surgical patients had lower scores than the patients who had non-operative treatment.

  • Satisfaction with Symptoms
    • Patients are asked, "If you had to spend the rest of your life with the symptoms you have now, how would you feel about it?"

      This chart shows the percent of patients who responded that they are very or somewhat satisfied with their current symptoms.

      We get the results from the questionnaires filled out by the participants in SPORT who have spinal stenosis.

      This chart shows:
      - Satisfaction with symptoms; a higher score is better.
      - After treatment, the surgical patients had higher scores than the patients who had non-operative treatment.

  • Satisfaction with Care
    • Patients are asked, "Overall, how satisfied are you with the care you received for your spine-related problem?"

      This chart shows the percent of patients who responded that they are very or somewhat satisfied with their care.

      We get the results from the questionnaires filled out by the participants in SPORT who have spinal stenosis.

      This chart shows:
      - Satisfaction with care; a higher score is better.
      - After treatment, the surgical patients had higher scores than the patients who had non-operative treatment.

• MAKING DECISIONS ABOUT TREATMENT
  
  Learn about how patients with spinal stenosis made decisions about treatment more... at DHMC. This section has information about how good information leads to good decisions. Patients who are eligible for surgery to treat spinal stenosis are referred to the Center for Shared Decision Making.
  • Overview

    • For some patients with spinal stenosis, surgery is an option for treatment. Those patients are referred to the Center for Shared Decision Making at DHMC.

      The Center for Shared Decision Making is a free service to assist our patients in making a healthcare decision. The center offers one-on-one counseling, videos, audiotapes, booklets, CD-ROMS, and websites, as well as take-home decision aids.

      If you are facing a decision about treatment for spinal stenosis, or any other healthcare decision, we encourage you to visit the Center for Shared Decision Making at DHMC. Call (603) 650-5578 for more information.

      Below is information about spinal stenosis patients who visited the Center for Shared Decision Making. The information is gathered from surveys filled out after watching a video on treatment options.
      
      

      Between January 2006 and December 2007, a total of 1264 DHMC Spine Center patients borrowed videos about treatment decisions for spinal stenosis/degenerative spondylolisthesis and 626 of those patients filled out a survey after watching the video.

      The average age of those patients was 68 years old.

  • Patient Response to treatment options video
    • After watching a video about spinal stenosis treatment options, patients filled out a survey.

      Most patients felt that the video had clear information.

      Most patients felt the information was unbiased.

      Most patients would recommend the video to others.

  • Factors in making a good decision
    • Part of making a good decision is understanding the treatment options, the risks and benefits of those options, and knowing which benefits are more important to you.

      After watching a video about spinal stenosis treatment options, patients filled out a survey.

      Most patients responded that they knew the treatment options and the risks and benefits for each option.

      Most patients responded that they were clear about which benefits mattered to them.

  • Results after watching treatment options video

    • After watching the video, 23% of patients changed their minds about which treatment option they preferred.

      After watching the video, more patients are choosing the treatment that is best for them and fewer patients are unsure about their decision.