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Back surgery rates in the United States are rising rapidly, according to the Agency for Healthcare Quality and Research in Rockville, MD. A recent study in Medical Care finds that an interactive video helps patients make better decisions about whether or not to undergo elective back surgery.
Researchers randomly assigned 171 patients with a range of back problems including herniated disks and spinal stenosis into two groups. One group saw an interactive video and received an educational booklet about surgery for their condition; the second group received the booklet alone.
Symptom and function outcomes at three months and 12 months were similar for the two groups, but the overall surgery rate was 22% lower in the video group. Patients with herniated disks in the video group who learned that their problem usually improves with non-surgical care had a surgical rate of 32% compared to 47% for the booklet-only group. Patients with spinal stenosis in the video group who learned their condition would probably stay the same for years without surgery had higher surgery rates than the booklet-only group — 39% compared to 29%.
The video had little effect on patient satisfaction, but patients in the video group felt better informed than patients in the booklet-only group, researchers note.
[See: Deyo RA, Cherkin DC, Weinstein J, et al. Involving patients in clinical decisions: Impact of an interactive video program on use of back surgery. Medical Care 2000; 38:959-969.