{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,31]],"date-time":"2026-10-31T12:35:49Z","timestamp":1793450149093,"version":"4.5.0"},"reference-count":35,"publisher":"SAGE Publications","issue":"5","license":[{"start":{"date-parts":[[2025,11,16]],"date-time":"2025-11-16T00:00:00Z","timestamp":1763251200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2025,11,16]],"date-time":"2025-11-16T00:00:00Z","timestamp":1763251200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Global Spine Journal"],"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:sec>\n                    <jats:title>Study Design<\/jats:title>\n                    <jats:p>Prospective Cohort Study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>This study aimed to (1) compare anticipated and encountered post-operative barriers following lumbar decompression surgery, (2) assess the relationship between encountering barriers and achieving meaningful improvement (MCID) in Oswestry Disability Index (ODI) scores, and (3) evaluate the association between socioeconomic status and encountered barriers via Social Vulnerability Index (SVI).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Patients completed pre-operative surveys assessing anticipated recovery barriers and ODI. Post-operative surveys collected 6 weeks post-operation captured encountered barriers and ODI. Barriers were quantified with a 1-5 Likert scale. Wilcoxon Rank Sign tests assessed differences between anticipated and encountered barriers. Logistic regression evaluated associations between barriers and achievement of ODI MCID. Spearman correlation tested associations between SVI and barrier frequency.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Patients were generally able to predict post-operative barriers accurately. Exercise adherence, financial stress, and care understanding were frequently reported concerns. Five post-operative barriers decreased the likelihood of achieving MCID: difficulty meeting exercise goals (OR = 0.43,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.00036), difficulty obtaining medications (OR = 0.32,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.030), transportation challenges (OR = 0.42,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.036), communication issues with the care team (OR = 0.52,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.015), and limited understanding of care plan (OR = 0.58,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.044). Higher SVI scores correlated with difficulty obtaining medications (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.035) and increased financial stress (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.033).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Post-operative recovery challenges\u2014particularly in exercise adherence, medication access, transportation, and care plan comprehension\u2014are associated with reduced odds of functional improvement. Higher social vulnerability exacerbates specific barriers. These findings underscore the importance of individualized peri-operative planning to optimize outcomes in lumbar decompression surgery.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/21925682251400326","type":"journal-article","created":{"date-parts":[[2025,11,17]],"date-time":"2025-11-17T05:48:02Z","timestamp":1763358482000},"page":"2202-2211","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["Barriers to Adhering to Post-operative Recovery in Spinal Decompression Surgery and Impact on Patient-Reported Outcomes"],"prefix":"10.1177","volume":"16","author":[{"given":"Paul","family":"Wilson","sequence":"first","affiliation":[{"name":"Virginia Mason Medical Center"},{"name":"University of Washington School of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kiumars","family":"Edalati","sequence":"additional","affiliation":[{"name":"Virginia Mason Medical Center"},{"name":"University of Washington School of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Jeffko","sequence":"additional","affiliation":[{"name":"Virginia Mason Medical Center"},{"name":"University of Washington School of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6787-5501","authenticated-orcid":false,"given":"Aiyush","family":"Bansal","sequence":"additional","affiliation":[{"name":"Virginia Mason Medical Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patricia","family":"Lipson","sequence":"additional","affiliation":[{"name":"Virginia Mason Medical Center"},{"name":"University of Washington School of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-8303-367X","authenticated-orcid":false,"given":"Kenneth Thinh","family":"Nguyen","sequence":"additional","affiliation":[{"name":"Virginia Mason Medical Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jerry","family":"Du","sequence":"additional","affiliation":[{"name":"Virginia Mason Medical Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eric","family":"Varley","sequence":"additional","affiliation":[{"name":"Virginia Mason Medical Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4787-1538","authenticated-orcid":false,"given":"Philip K.","family":"Louie","sequence":"additional","affiliation":[{"name":"Virginia Mason Medical Center"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,11,16]]},"reference":[{"key":"e_1_3_5_2_2","doi-asserted-by":"publisher","DOI":"10.3171\/2016.11.SPINE16526"},{"key":"e_1_3_5_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.apmr.2020.12.028"},{"key":"e_1_3_5_4_2","doi-asserted-by":"publisher","DOI":"10.1093\/pm\/pnz280"},{"key":"e_1_3_5_5_2","doi-asserted-by":"publisher","DOI":"10.1111\/jgs.15809"},{"key":"e_1_3_5_6_2","doi-asserted-by":"publisher","DOI":"10.1093\/pm\/pnz090"},{"key":"e_1_3_5_7_2","doi-asserted-by":"publisher","DOI":"10.1155\/2020\/4283027"},{"key":"e_1_3_5_8_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00586-010-1433-7"},{"key":"e_1_3_5_9_2","doi-asserted-by":"publisher","DOI":"10.4184\/asj.2017.11.2.319"},{"key":"e_1_3_5_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.xnsj.2022.100187"},{"key":"e_1_3_5_11_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12913-022-07976-6"},{"key":"e_1_3_5_12_2","doi-asserted-by":"publisher","DOI":"10.1093\/intqhc\/mzm011"},{"key":"e_1_3_5_13_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11605-019-04435-2"},{"key":"e_1_3_5_14_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12889-020-08498-8"},{"key":"e_1_3_5_15_2","doi-asserted-by":"publisher","DOI":"10.1177\/2150131917697439"},{"key":"e_1_3_5_16_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjsurg.2021.07.052"},{"key":"e_1_3_5_17_2","doi-asserted-by":"publisher","DOI":"10.21037\/jss.2017.08.05"},{"key":"e_1_3_5_18_2","doi-asserted-by":"publisher","DOI":"10.1097\/BRS.0000000000004344"},{"key":"e_1_3_5_19_2","doi-asserted-by":"publisher","DOI":"10.31616\/asj.2019.0032"},{"key":"e_1_3_5_20_2","doi-asserted-by":"publisher","DOI":"10.2202\/1547-7355.1792"},{"key":"e_1_3_5_21_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.spinee.2022.11.001"},{"key":"e_1_3_5_22_2","unstructured":"Flanagan BE Gregory EW Hallisey EJ Heitgerd JL Lewis B. 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