International Journal of Clinical Science and Medical Research

Background: Patients awaiting spinal surgery commonly experience fear and uncertainty, which may influence recovery. Data from Nigerian spine units are scarce. This prospective study characterised patient‑reported worries before spinal surgery and determined whether worries predict surgical outcome.

Methods: A prospective questionnaire‑based study of 350 consecutive patients scheduled for spinal surgery at the National Orthopaedic Hospital Dala, Kano, between January 2022 and June 2025 was conducted. A purpose‑designed 12‑item Spinal Surgery Worry Questionnaire (SSWQ), the Hospital Anxiety and Depression Scale (HADS), the Oswestry Disability Index (ODI) and a Visual Analogue Scale (VAS) were administered preoperatively. Patients were followed for 12 months. Outcomes were classified as good (ODI improvement ≥15 points and VAS reduction ≥50%) or poor.

Results: Mean SSWQ score was 22.6±9.8 out of 48; 168 patients (48.0%) were classified as highly worried (score ≥24). The most frequent worries were paralysis (78.0%), surgical cost (71.4%) and failure to relieve pain (65.1%). At 12 months, high worry was associated with smaller ODI improvement (17.8±13.2 vs 28.4±14.6, p<0.001), higher residual pain (4.1±1.9 vs 2.9±1.7, p<0.001) and lower satisfaction (67.9% vs 84.1%, p<0.001). Fusion rates were similar (88.1% vs 89.6%, p=0.65). On multivariate analysis, high worry independently predicted poor outcome (adjusted OR 2.6, 95% CI: 1.4-4.9), together with preoperative neurological deficit and multilevel surgery.

Conclusions: Preoperative worry is highly prevalent and predicts poorer functional recovery after spinal surgery, but does not compromise fusion. Routine psychological screening and targeted reassurance should be integrated into preoperative care.

Preoperative worry, spinal surgery, patient expectations, psychological distress, patient‑reported outcomes, Nigeria

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