The impact on fluoroscopic image review on perceived benefit, patient satisfaction, and short-term improvement following lumbosacral epidural steroid injections

Background

Interventional spine and pain physicians rarely review fluoroscopic images with their patients following spine procedures. Despite high patient satisfaction with these procedures, there may be further steps to enhance the patient experience.

Objectives

The purpose of this study is to analyze the impact of physician's post-procedure fluoroscopic image review on perceived benefit, patient satisfaction, and short-term improvement.

Methods

This single blinded prospective comparative study evaluated post-procedure questionnaires following non-sedation lumbosacral transforaminal epidural steroid injection (TFESIs). The control group received a scripted verbal explanation of the procedure results. The intervention group received a similar explanation that was enhanced with a review of the fluoroscopic procedure images. The perceived benefit was assessed by asking the participants to rate the degree of helpfulness of image review. A modified Press Ganey Satisfaction Questionnaire was used to assess patient satisfaction. Short-term improvement following the procedure was measured at two weeks with a Patient Global Impression of Change (PGIC). In the case of missing PGIC data, manual chart reviews were conducted to assess outcomes.

Results

The control group (no image review) included 70 participants, while the intervention group (image reviewed) included 71. There were 95.8 % of the intervention group that rated their actual image review as helpful to very helpful, while 68.6 % of the control group felt that image review would have been helpful to very helpful. The intervention group also reported significantly higher confidence in their provider (p = 0.03). There was no significant difference between groups in other domains of patient satisfaction or short-term improvement following the spine procedure.

Conclusion

Consistent with prior literature, all participants reported high satisfaction following a lumbosacral TFESI. This study demonstrated that a brief post-procedure image review was highly beneficial and improved confidence in the care providers, whereas the control group likely underestimated the potential helpfulness of receiving an image review. Further studies are required to explore the best use of post-procedure image review and the potential further impact on patient-centered care.

Registered

ClinicalTrials.gov NCT05884684.