A qualitative exploration of unmet healthcare needs for individuals undergoing surgery for symptomatic lumbar spinal stenosis

Nora Bakaa; James Gillet; Raja Rampersaud; Brian Drew; Aleksa Cenic; Lisa Carlesso; Joy MacDermid; Douglas P Gross; Joanne Thorne; Luciana Gazzi Macedo

doi:10.1080/09638288.2025.2520995

A qualitative exploration of unmet healthcare needs for individuals undergoing surgery for symptomatic lumbar spinal stenosis

Disabil Rehabil. 2025 Jun 17:1-8. doi: 10.1080/09638288.2025.2520995. Online ahead of print.

Authors

Affiliations

¹ Department of Rehabilitation Sciences, McMaster University, Hamilton, Canada.
² Faculty of Social Sciences, McMaster University, Hamilton, Canada.
³ Toronto Western Hospital, University of Toronto, Toronto, Canada.
⁴ Department of Surgery, McMaster University, Hamilton, Canada.
⁵ School of Physical Therapy, University of Western Ontario, London, Canada.
⁶ Department of Physical Therapy, University of Alberta, Edmonton, Canada.
⁷ Patient Partner, Hamilton, Canada.

PMID: 40528327
DOI: 10.1080/09638288.2025.2520995

Abstract

Purpose: This study aimed to gain an in-depth perspective of the perioperative experiences, including unmet needs and expectations, of individuals with the Canadian healthcare system before or after surgery for symptomatic lumbar spinal stenosis (SLSS).

Methods: We used qualitative interpretive phenomenology to study individuals with SLSS. We conducted semi-structured qualitative interviews that lasted 30 to 90 min. Inclusion criteria were individuals 55 or older, diagnosed with SLSS, scheduled for or undergone lumbar spine surgery, and able to speak English.

Results: A total of 32 participants (Men: n = 18; Women: n = 14) were included in this study. Among those participants, 15 were interviewed preoperatively (before surgery) and 17 postoperatively (after surgery). Patients described varied perioperative challenges, requiring a tailored approach to meet their unique needs. We constructed 4 major themes that participants highlighted as factors affecting their perioperative experience: (1) Frustration and barriers to navigating the healthcare system, (2) Insufficient education and preparation for surgery, (3) Challenges with postoperative recovery and rehabilitation, and (4) Unmet needs for peer and emotional support.

Conclusion: This study highlights the importance of developing patient-centered perioperative standard of care to help individuals undergoing surgery for SLSS navigate the Ontario healthcare system.

Keywords: Lumbar spinal stenosis; phenomenology; prehabilitation; qualitative; spine surgery.

Plain language summary

A standardized preoperative rehabilitation intervention for individuals with symptomatic lumbar spinal stenosis may help improve patient satisfaction with care.Better communication among patients and healthcare providers and culturally sensitive resources are needed to ensure equitable healthcare accessibility.Designing a preoperative support system that includes a peer mentorship program may help reduce underlying anxiety related to surgery.Comprehensive management strategies that include biological and psychosocial factors may improve the perioperative experience.