• Alison Rushton, Bini Elena, Feroz Jadhakhan, Annabel Masson, J Bart Staal, Martin L Verra, Andrew Emms, Michael Reddington, Ashley Cole, Paul C Willems, Lorin Benneker, Nicola R Heneghan, and Andrew Soundy.
• School of Physical Therapy, Faculty of Health Sciences, Western University, London, ON, Canada. arushto3@uwo.ca.
• Eur Spine J. 2022 Dec 1; 31 (12): 359036023590-3602.

PurposeTo understand the patient journey to Lumbar Spinal Fusion Surgery (LSFS) and patients' experiences of surgery.MethodsQualitative study using interpretive phenomenological analysis. Adult participants following LSFS were recruited from 4 UK clinical sites using purposive sampling to ensure representation of key features (e.g. age). Semi-structured interviews informed by a piloted topic guide developed from the literature were audio-recorded and transcribed verbatim. Framework analysis for individual interviews and then across participants (deductive and inductive) identified emerging themes. Trustworthiness of data analyses was enhanced using multiple strategies (e.g. attention to negative cases).ResultsFour emerging themes from n = 31 patients' narratives were identified: decision for surgery, coping strategies, barriers to recovery and recovery after surgery. Decision for surgery and recovery after surgery themes are distinguished by the point of surgery. However, barriers to recovery and coping strategies are key to the whole patient journey encompassing long journeys to surgery and their initial journey after surgery. The themes of coping strategies and barriers to recovery were inter-related and perceived by participants as parallel concepts. The 4 multifactorial themes interacted with each other and shaped the process of an individual patient's recovery. Factors such as sporadic interventions prior to surgery, time-consuming wait for diagnosis and surgery and lack of information regarding recovery strongly influenced perceptions of outcome.ConclusionPatient driven data enables insights to inform research regarding surgery/rehabilitation through depth of understanding of the patient journey. Awareness of factors important to patients is important; ensuring that patient-driven data informs research and patient care.© 2022. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.

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