Consent for spine surgery: an observational study.

摘要: Background The tension between the ideal of informed consent and reality process is under-investigated in spine surgery. Guidelines around imply a logical, plain-speaking with clear endpoint, agreement signature yet surgeons' surveys patient interviews suggest that explanation anecdotally variable understanding remains poor. To obtain more authentic reflection practice, surgeons obtaining 'informed consent' for non-instrumented surgery were studied via video recording risk/benefit discussions analysed. Methods A prospective observational study was conducted at single neurosurgical institution. Twelve recordings involving six an transcribed verbatim blindly analysed using descriptive quantification linguistic ethnography. Results Ten (83%) consultations discussed surgical benefit but less than half (41%) quantified likelihood from most risks nerve damage or paralysis (92%), bleeding infection cerebrospinal fluid leak bowel bladder dysfunction (75%). Surgeons commonly used quantitative statement risk (58%) only explained words patients likely to understand. Conclusions This highlights inconsistencies way explain 'simple' procedures real-world setting. There are wide disparities provision consent, which may be encountered other fields. Direct observation qualitative analysis can provide insights into limitations current practice help guide future practice.