Introduction: Patient satisfaction reflects patients’ perception of outcome of care and has been considered for use in reimbursement schemes. No consensus on patient satisfaction instruments exists in spine surgery. The goals of this systematic review are to establish how patient satisfaction with spine surgery has been previously measured, determine if there is a disease-specific, comprehensive instrument to measure patient satisfaction, and to define the dimensions of care that determine patient satisfaction in spine surgery.

Methods: A systematic search of three online databases, unpublished sources, and citations was undertaken to identify 156 empirical studies reporting patient satisfaction with spine surgery. Manuscripts were reviewed for patient satisfaction instrument used and instruments were categorized by content and method axes. A taxonomy of patient satisfaction with spine surgery identified the major characteristics of providers and medical care influencing patient satisfaction and acted as a structure to categorically define the dimensions of patient satisfaction in spine surgery.

Results: Studies used predominantly global (108/156), rather than multidimensional (46/156), instruments. Most studies (96.2%) reported satisfaction with outcome rather than care, and only 18.5% of studies identified (29/156) utilized a disease-specific instrument. Seven dimensions of patient status, outcome and care experience affecting patient satisfaction were identified: pain, function, patient expectations/preference, specific patient health characteristics, caregiver interpersonal manner, efficacy/clinical outcomes, and postoperative care/therapy.

Conclusions: Currently, no instrument exists that is disease- specific and covers all dimensions of patient satisfaction in spine surgery. Such a patient satisfaction instrument should be designed, tested for reliability and validity, and widely implemented.

Patient Care: The development of a validated instrument to measure patient satisfaction in the spine patient population will give a novel outcome measure to be used in future clinical practice and research.

Learning Objectives: By the conclusion of this session, participants should be able to: 1)Describe the axes of patient satisfaction 2)Discuss the current state of the measurement of patient satisfaction with regards to spinal surgery 3)Discuss factors that consistently impact satisfaction with spinal surgery

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