{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,12]],"date-time":"2026-03-12T00:36:39Z","timestamp":1773275799036,"version":"3.50.1"},"reference-count":42,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2020,10,5]],"date-time":"2020-10-05T00:00:00Z","timestamp":1601856000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["ANZ Journal of Surgery"],"published-print":{"date-parts":[[2021,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>The tension between the ideal of informed consent and the reality of the process is under\u2010investigated in spine surgery. Guidelines around consent imply a logical, plain\u2010speaking process with a clear endpoint, agreement and signature yet surgeons' surveys and patient interviews suggest that surgeons' explanation is anecdotally variable and patient understanding remains poor. To obtain a more authentic reflection of practice, spine surgeons obtaining \u2018informed consent\u2019 for non\u2010instrumented spine surgery were studied via video recording and risk\/benefit discussions were analysed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A prospective observational study was conducted at a single neurosurgical institution. Twelve video recordings involving six surgeons obtaining an informed consent for non\u2010instrumented spine surgery were transcribed verbatim and blindly analysed using descriptive quantification and linguistic ethnography.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Ten (83%) consultations discussed surgical benefit but less than half (41%) quantified the likelihood of benefit from surgery. The most discussed risks were nerve damage or paralysis (92%), bleeding (92%), infection (92%), cerebrospinal fluid leak (83%) and bowel and bladder dysfunction (75%). Surgeons commonly used a quantitative statement of risk (58%) but only half of the risks were explained in words patients were likely to understand.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>This study highlights inconsistencies in the way spine surgeons explain risks and obtain informed consent for \u2018simple\u2019 spine procedures in a real\u2010world setting. There are wide disparities in the provision of informed consent, which may be encountered in other surgical fields. Direct observation and qualitative analysis can provide insights into the limitations of current informed consent practice and help guide future practice.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ans.16348","type":"journal-article","created":{"date-parts":[[2020,10,6]],"date-time":"2020-10-06T06:32:43Z","timestamp":1601965963000},"page":"1220-1225","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Consent for spine surgery: an observational study"],"prefix":"10.1111","volume":"91","author":[{"given":"Angela","family":"Li Ching Ng","sequence":"first","affiliation":[{"name":"Macquarie Neurosurgery Macquarie University Clinic  Sydney New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5492-1903","authenticated-orcid":false,"given":"Lucinda S.","family":"McRobb","sequence":"additional","affiliation":[{"name":"Department of Clinical Medicine Macquarie University  Sydney New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sarah J.","family":"White","sequence":"additional","affiliation":[{"name":"Department of Biomedical Sciences Macquarie University  Sydney New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John A.","family":"Cartmill","sequence":"additional","affiliation":[{"name":"Department of Clinical Medicine Macquarie University  Sydney New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Allan M.","family":"Cyna","sequence":"additional","affiliation":[{"name":"Discipline of Acute Care Medicine University of Adelaide  Adelaide South Australia Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kevin","family":"Seex","sequence":"additional","affiliation":[{"name":"Macquarie Neurosurgery Macquarie University Clinic  Sydney New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2020,10,5]]},"reference":[{"key":"e_1_2_9_2_1","volume-title":"Code of Conduct for Registered Health Practitioners","author":"Australian Health Practitioner Regulation Agency","year":"2014"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamasurg.2017.0544"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/BRS.0000000000002510"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00586-018-5739-1"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.spinee.2017.06.038"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.spinee.2019.02.001"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1302\/0301-620X.101B4.BJJ-2018-1045.R2"},{"key":"e_1_2_9_9_1","unstructured":"Australian Commission on Safety and Quality in Health Care.Healthcare Rights and Informed Consent. 2019. 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