Choudhury Tahsin, Jung John, Barnes Monica, Chandran SriKrishna, Eckner James T, Geisser Michael, Kohns David J
University of Michigan Health System, Department of Physical Medicine and Rehabilitation, Ann Arbor, MI, USA.
Interv Pain Med. 2025 Aug 31;4(3):100640. doi: 10.1016/j.inpm.2025.100640. eCollection 2025 Sep.
Interventional spine and pain physicians rarely review fluoroscopic images with their patients following spine procedures. Despite high patient satisfaction with these procedures, there may be further steps to enhance the patient experience.
The purpose of this study is to analyze the impact of physician's post-procedure fluoroscopic image review on perceived benefit, patient satisfaction, and short-term improvement.
This single blinded prospective comparative study evaluated post-procedure questionnaires following non-sedation lumbosacral transforaminal epidural steroid injection (TFESIs). The control group received a scripted verbal explanation of the procedure results. The intervention group received a similar explanation that was enhanced with a review of the fluoroscopic procedure images. The perceived benefit was assessed by asking the participants to rate the degree of helpfulness of image review. A modified Press Ganey Satisfaction Questionnaire was used to assess patient satisfaction. Short-term improvement following the procedure was measured at two weeks with a Patient Global Impression of Change (PGIC). In the case of missing PGIC data, manual chart reviews were conducted to assess outcomes.
The control group (no image review) included 70 participants, while the intervention group (image reviewed) included 71. There were 95.8 % of the intervention group that rated their actual image review as helpful to very helpful, while 68.6 % of the control group felt that image review would have been helpful to very helpful. The intervention group also reported significantly higher confidence in their provider (p = 0.03). There was no significant difference between groups in other domains of patient satisfaction or short-term improvement following the spine procedure.
Consistent with prior literature, all participants reported high satisfaction following a lumbosacral TFESI. This study demonstrated that a brief post-procedure image review was highly beneficial and improved confidence in the care providers, whereas the control group likely underestimated the potential helpfulness of receiving an image review. Further studies are required to explore the best use of post-procedure image review and the potential further impact on patient-centered care.
ClinicalTrials.gov NCT05884684.
脊柱介入与疼痛科医生在脊柱手术后很少与患者一起查看透视影像。尽管患者对这些手术的满意度很高，但仍可能有进一步提升患者体验的措施。
本研究旨在分析医生术后透视影像回顾对患者感知到的益处、患者满意度及短期改善情况的影响。
这项单盲前瞻性对照研究评估了非镇静状态下腰骶部经椎间孔硬膜外类固醇注射（TFESI）术后的问卷调查情况。对照组接受关于手术结果的书面口头解释。干预组除了类似的解释外，还通过回顾透视手术影像进行强化。通过让参与者对影像回顾的帮助程度进行评分来评估感知到的益处。使用改良的Press Ganey满意度问卷来评估患者满意度。术后两周采用患者整体变化印象（PGIC）来衡量短期改善情况。若PGIC数据缺失，则进行手工病历审查以评估结果。
对照组（无影像回顾）有70名参与者，干预组（有影像回顾）有71名。干预组中有95.8%的人将实际的影像回顾评为有帮助到非常有帮助，而对照组中有68.6%的人认为影像回顾会有帮助到非常有帮助。干预组对其医疗服务提供者的信心也显著更高（p = 0.03）。在脊柱手术后患者满意度的其他方面或短期改善情况方面，两组之间没有显著差异。
与先前文献一致，所有参与者在腰骶部TFESI术后均报告了较高的满意度。本研究表明，术后简短的影像回顾非常有益，并提高了对医疗服务提供者的信心，而对照组可能低估了接受影像回顾的潜在帮助。需要进一步研究以探索术后影像回顾的最佳应用方式以及对以患者为中心的护理的潜在进一步影响。
ClinicalTrials.gov NCT05884684
