Psychological distress does not predict decisional regret in patients undergoing spinal reconstruction for adult spinal deformity

BMC Musculoskelet Disord. 2024 Dec 3;25(1):989. doi: 10.1186/s12891-024-08126-1.

Abstract

Purpose: The study aimed to assess the link between preoperative psychological distress and postoperative decisional regret in adult spinal deformity (ASD) surgery patients. We hypothesized that greater pre-surgery distress would correlate with higher post-surgery regret. This evaluation was based on a retrospective case series from an institution with standardized surgical guidelines for ASD.

Methods: This IRB-approved retrospective study analyzed our institution's ASD database from 2014 to 2020. Eligible patients had a minimum two-year post-op follow-up and preoperative psychological distress assessment. Patients were grouped based on psychological distress levels: green, yellow, and yellow minus. Regret post-surgery was assessed using the Decision Regret Scale and SRS-22 Question 22. Logistic regression evaluated the impact of distress levels on regret, controlling for age and sex.

Results: Out of 167 eligible patients, 112 responded and were analyzed. No significant demographic differences were observed between responders and non-responders. Using the Decision Regret Scale, 41% expressed no regret, while 63% expressed no regret with the SRS-22 questionnaire's Single-Item scale. Only the yellow minus group showed significant regret difference based on osteotomy, with non-recipients more likely to express regret.

Conclusion: This study found no significant link between psychological distress and post-operative regret in adult spinal deformity surgery after a minimum 2-year follow-up. Although nearly 60% exhibited some post-surgery regret, predicting regret based on psychological burden or demographics remains challenging. Further research is essential to identify factors contributing to post-operative regret in spinal deformity surgery patients.

Keywords: Adult spinal deformity; Decisional regret; Psychological regret; SRS-22.

MeSH terms

  • Adult
  • Aged
  • Decision Making*
  • Emotions*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Plastic Surgery Procedures / psychology
  • Psychological Distress*
  • Retrospective Studies
  • Spinal Curvatures / psychology
  • Spinal Curvatures / surgery
  • Surveys and Questionnaires