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Research ArticleEndoscopic Minimally Invasive Surgery

Patient Perspectives on Awake Transforaminal Endoscopic Decompression Surgery Outcomes

Albert E. Telfeian, Rohaid Ali, Sanjay Konakondla and Kai-Uwe Lewendrowski
International Journal of Spine Surgery May 2025, 8763; DOI: https://doi.org/10.14444/8763
Albert E. Telfeian
1 Department of Neurosurgery, Rhode Island Hospital, The Warren Alpert Medical School of Brown University, Providence, RI, USA
MD, PhD
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  • For correspondence: aetelfeian@gmail.com
Rohaid Ali
2 Department of Neurosurgery, Geisinger Neuroscience Institute, Danville, PA, USA
MD
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Sanjay Konakondla
2 Department of Neurosurgery, Geisinger Neuroscience Institute, Danville, PA, USA
MD
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Kai-Uwe Lewendrowski
3 Division Personalized Pain Research and Education, Center for Advanced Spine Care of Southern Arizona, Tucson, AZ, USA
MD
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    Figure 1

    Perceptions of surgical outcomes and recovery after awake transforaminal endoscopic decompression. This figure illustrates responses from 102 patients on the extent to which surgical outcomes met expectations. The mean satisfaction rating was 4.3, mean satisfaction with the need for additional postsurgical care was 4.3, mean impact of reduced pain on quality of lifewas 4.1, and mean the level of pain experienced during recovery of 3.5.

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    Figure 2

    Assessment of recovery and procedural impact after awake transforaminal endoscopic decompression. This figure presents data from 102 respondents regarding pain and discomfort during recovery, with a mean score of 3.5. The impact of the endoscopic procedure on overall well-being had a mean rating of 4.1. The mean likelihood of recommending the procedure to others was 4.5, and the thoroughness of the surgeon’s explanation of expected outcomes was rated highly at 4.7.

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    Figure 3

    Evaluations of surgical outcomes and symptom management after awake transforaminal endoscopic decompression. This figure presents data from 102 respondents, showing how surgical results aligned with explanations (mean rating of 4.3) and pain medication usage frequencies (mean rating of 3.4). It also details the utilization of various treatments like anti-inflammatories, prescription painkillers, physical therapy, and chiropractic care among 93 respondents. Additionally, it reflects opinions on endoscopic vs traditional spine surgery from 89 respondents, with a majority strongly agreeing on better outcomes with endoscopic methods.

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    Figure 4

    The person-item map illustrates the distribution of patients’ abilities and unmet expectations regarding their surgical experience. The middle clustering highlights moderate abilities across patients. The logical progression of the logits from 1 to 4 for items F, B, E, and D, shown as black lines, represents the increasing levels of agreement or response categories for these items. The location of the mean logit (black solid dot) indicates the average level of challenge or ease with which patients agreed with each survey question. Item (F) “How likely are you to recommend this procedure to others with similar conditions?”: The placement of its mean logit suggests that most patients found it easy to agree, aligning with the “very high” agreement level. Item (B) “How satisfied were you with the need for additional care?” and item (E) “How would you rate the endoscopic procedure’s impact on your overall well-being?”: Their mean logits indicate moderate ease of agreement, reflecting the mixed levels of satisfaction and perceived impact. Item (D) “How much pain or discomfort did you experience during the recovery process?”: The mean logit’s position shows variable responses, suggesting that pain during recovery was more challenging to evaluate consistently among patients. Item thresholds indicate varied expectations, with “To what extent did the surgical outcome meet your expectations?” (A) showing moderate unmet expectations. Items such as “How satisfied were you with the need for additional care?” (C) indicating high satisfaction and recommendation likelihood. Communication effectiveness is noted through (G) “How thoroughly did your surgeon explain the expected outcomes?”, where variability suggests areas for improvement.

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    Figure 5

    The person-item map illustrates patient abilities and expectations regarding survey questions related to postoperative care and treatments. The gray bars represent the distribution of patient abilities, predominantly centered, indicating moderate agreement levels. Red lines and dots depict expectation thresholds across items, revealing consistent responses where thresholds are closely spaced and variability where they are wider. Items such as “physical therapy” (L) and “chiropractor” (M) show high agreement, while “How often do you still need pain medications?” (I) and “anti-inflammatories” (J) indicate more variability, reflecting diverse patient experiences. The map identifies areas of consistent satisfaction and opportunities for improvement, indicated by the lack of logical progression in some logits.

Tables

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    Table 1

    Patient responses by level of agreement on surgical experience.

    ItemSurvey QuestionMeasureInfitOutfitSE MeasureStrength of Patient Agreement
    FHow likely are you to recommend this procedure to others with similar conditions?−2.5490.8820.4660.162Very high
    ATo what extent did the surgical outcome meet your expectations?−1.7230.7160.5940.136High
    CTo what extent did the reduction in pain postsurgery improve your quality of life?−1.4730.6550.6730.131High
    EHow would you rate the endoscopic procedure’s impact on your overall well-being?−1.4730.6930.6290.131High
    BHow satisfied were you with the need for additional care?−2.0381.2951.4870.144Moderate
    GHow thoroughly did your surgeon explain the expected outcomes of the surgery?−3.3241.6921.2050.203Moderate
    DHow much pain or discomfort did you experience during the recovery process?−0.6341.5161.8040.120Variable
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    Table 2

    Patient responses by level of agreement on postoperative aftercare.

    ItemSurvey QuestionMeasureInfitOutfitSE MeasureStrength of Patient Agreement
    LPhysical therapy−0.9150.8860.6760.118High
    MChiropractor−1.3470.7990.7870.143High
    OAcupuncture−1.3071.0230.7730.140High
    QPain management doctor−1.1780.9270.5740.132High
    HHow did it turn out—as it was explained?−1.1781.0970.8620.132Moderate
    KPrescription pain killers−0.9291.1111.0350.119Moderate
    NMassage−0.8611.0191.0340.116Moderate
    ROther spine surgeon−1.3681.1461.3760.145Moderate
    IHow often do you still need pain medications?−0.5401.1591.2190.107Variable
    JAnti-inflammatories−0.5401.1521.4190.107Variable
    PYoga−1.1611.2031.2170.130Variable
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International Journal of Spine Surgery: 19 (S2)
International Journal of Spine Surgery
Vol. 19, Issue S2
1 Apr 2025
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Patient Perspectives on Awake Transforaminal Endoscopic Decompression Surgery Outcomes
Albert E. Telfeian, Rohaid Ali, Sanjay Konakondla, Kai-Uwe Lewendrowski
International Journal of Spine Surgery May 2025, 8763; DOI: 10.14444/8763

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Patient Perspectives on Awake Transforaminal Endoscopic Decompression Surgery Outcomes
Albert E. Telfeian, Rohaid Ali, Sanjay Konakondla, Kai-Uwe Lewendrowski
International Journal of Spine Surgery May 2025, 8763; DOI: 10.14444/8763
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Keywords

  • awake transforaminal endoscopic surgery
  • degenerative spine diseases
  • patient perceptions
  • minimally invasive spine surgery
  • surgical outcomes
  • patient satisfaction
  • preoperative communication
  • pain management
  • postoperative recovery
  • conservative treatments

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