{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,25]],"date-time":"2026-02-25T01:01:46Z","timestamp":1771981306632,"version":"3.50.1"},"reference-count":45,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,9,1]]},"abstract":"<jats:sec>\n<jats:title>OBJECTIVE<\/jats:title>\n<jats:p>Deficiency in patient education has been correlated with increased disease-related morbidity and decreased access to care. However, the associations between educational level, preoperative disease severity, and postoperative outcomes in patients with lumbar spondylolisthesis have yet to be explored.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>METHODS<\/jats:title>\n<jats:p>The spondylolisthesis dataset of the Quality Outcomes Database (QOD)\u2014a cohort with prospectively collected data by the SpineCORe study team of the 12 highest enrolling sites with an 81% follow-up at 5 years \u2014was utilized and stratified for educational level. Patients were classified into three categories (high school or less, graduate, or postgraduate). Patient-reported outcome measures (PROMs) documented at baseline and follow-up included Oswestry Disability Index (ODI) score, EQ-5D in quality-adjusted life years, and numeric rating scale (NRS) scores for back and leg pain. Disease severity was measured with PROMs. Postoperatively, patients also completed the North American Spine Society assessment to measure their satisfaction with surgery. Multivariable regression analysis was used to compare education level with disease severity and postoperative outcomes.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>RESULTS<\/jats:title>\n<jats:p>A total of 608 patients underwent analysis, with 260 individuals (42.8%) at an educational level of high school or less. On univariate analysis, baseline disease severity was worse among patients with lower levels of education. On multivariable regression analysis, patients with postgraduate level of education had significantly lower ODI scores (\u03b2 = \u22123.75, 95% CI \u22127.31 to \u22120.2, p = 0.039) compared to graduates, while the other PROMs were not associated with significant differences at baseline. Five years postoperatively, patients from various educational backgrounds exhibited similar rates of minimal clinically important differences in PROMs. Nevertheless, patients with the lowest educational level had higher ODI scores (27.1, p &lt; 0.01), lower EQ-5D scores (0.701, p &lt; 0.01), and higher NRS leg pain (3.0, p &lt; 0.01) and back pain (4.0, p &lt; 0.01) scores compared to those with graduate or postgraduate levels of education. The odds for postoperative satisfaction were also comparable between cohorts at 5 years (reference, graduate level; high school or less, OR 0.87, 95% CI 0.46\u20131.64, p = 0.659; postgraduate, OR 1.6, 95% CI 0.7\u20133.65, p = 0.262).<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>CONCLUSIONS<\/jats:title>\n<jats:p>Lower patient education level was associated with a greater baseline disease severity in patients with lumbar spondylolisthesis. Surgery demonstrated similar benefits irrespective of educational background; however, individuals with lower educational level reported lower outcomes overall. This emphasizes the need for enhanced health literacy to mitigate disparities for reported outcomes.<\/jats:p>\n<\/jats:sec>","DOI":"10.3171\/2024.3.spine231024","type":"journal-article","created":{"date-parts":[[2024,6,1]],"date-time":"2024-06-01T02:36:01Z","timestamp":1717209361000},"page":"341-352","source":"Crossref","is-referenced-by-count":5,"title":["Impact of educational background on preoperative disease severity and postoperative outcomes among patients with lumbar spondylolisthesis: a Quality Outcomes Database study"],"prefix":"10.3171","volume":"41","author":[{"given":"Nitin","family":"Agarwal","sequence":"first","affiliation":[{"name":"Department of Neurological Surgery, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania;"},{"name":"Department of Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrew K.","family":"Chan","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Columbia University Irving Medical Center, New York, New York;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Erica F.","family":"Bisson","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of Utah, Salt Lake City, Utah;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Steven D.","family":"Glassman","sequence":"additional","affiliation":[{"name":"Norton Leatherman Spine Center, Louisville, Kentucky;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kevin T.","family":"Foley","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Semmes Murphey Neurologic and Spine Institute, University of Tennessee, Memphis, Tennessee;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christopher I.","family":"Shaffrey","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Duke University, Durham, North Carolina;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Oren N.","family":"Gottfried","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Duke University, Durham, North Carolina;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Luis M.","family":"Tumial\u00e1n","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Barrow Neurological Institute, Phoenix, Arizona;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eric A.","family":"Potts","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, Goodman Campbell Brain and Spine, Indianapolis, Indiana;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mark E.","family":"Shaffrey","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of Virginia, Charlottesville, Virginia;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Domagoj","family":"Coric","sequence":"additional","affiliation":[{"name":"Neuroscience Institute, Carolina Neurosurgery & Spine Associates, Carolinas Healthcare System, Charlotte, North Carolina;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John J.","family":"Knightly","sequence":"additional","affiliation":[{"name":"Atlantic Neurosurgical Specialists, Morristown, New Jersey;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sufyan","family":"Ibrahim","sequence":"additional","affiliation":[{"name":"Department of Neurologic Surgery, Mayo Clinic, Rochester, Minnesota;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rida","family":"Mitha","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Giorgos","family":"Michalopoulos","sequence":"additional","affiliation":[{"name":"Department of Neurologic Surgery, Mayo Clinic, Rochester, Minnesota;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paul","family":"Park","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of Michigan, Ann Arbor, Michigan;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael Y.","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, University of Miami, Florida;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kai-Ming","family":"Fu","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, Weill Cornell Medical Center, New York, New York;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jonathan R.","family":"Slotkin","sequence":"additional","affiliation":[{"name":"Geisinger Health, Danville, Pennsylvania;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anthony L.","family":"Asher","sequence":"additional","affiliation":[{"name":"Atlantic Neurosurgical Specialists, Morristown, New Jersey;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael S.","family":"Virk","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, Weill Cornell Medical Center, New York, New York;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jian","family":"Guan","sequence":"additional","affiliation":[{"name":"Pacific Neuroscience Institute, Torrance, California;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Regis W.","family":"Haid","sequence":"additional","affiliation":[{"name":"Atlanta Brain and Spine Care, Atlanta, Georgia; and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dean","family":"Chou","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Columbia University Irving Medical Center, New York, New York;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mohamad","family":"Bydon","sequence":"additional","affiliation":[{"name":"Department of Neurologic Surgery, Mayo Clinic, Rochester, Minnesota;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Praveen V.","family":"Mummaneni","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of California, San Francisco, California"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1754","reference":[{"issue":"2","key":"b1","series-title":"Spine (Phila Pa 1976)","first-page":"199","article-title":"Spondylolysis and spondylolisthesis: prevalence and association with low back pain in the adult community-based population","volume":"34","author":"Kalichman L","year":"2009","unstructured":"Kalichman L, Kim DH, Li L, Guermazi A, Berkin V, Hunter DJ. Spondylolysis and spondylolisthesis: prevalence and association with low back pain in the adult community-based population. Spine (Phila Pa 1976). 2009;34(2):199\u2013205."},{"issue":"6","key":"b2","series-title":"Neurosurgery","first-page":"1033","article-title":"Classifying patients operated for spondylolisthesis: a K-means clustering analysis of clinical presentation phenotypes","volume":"89","author":"Chan AK","year":"2021","unstructured":"Chan AK, Wozny TA, Bisson EF,  Classifying patients operated for spondylolisthesis: a K-means clustering analysis of clinical presentation phenotypes. Neurosurgery. 2021;89(6):1033\u20131041."},{"issue":"1","key":"b3","series-title":"Orthopedics","first-page":"e1","article-title":"Workers\u2019 compensation, return to work, and lumbar fusion for spondylolisthesis","volume":"39","author":"Anderson JT","year":"2016","unstructured":"Anderson JT, Haas AR, Percy R, Woods ST, Ahn UM, Ahn NU. Workers\u2019 compensation, return to work, and lumbar fusion for spondylolisthesis. Orthopedics. 2016;39(1):e1\u2013e8."},{"issue":"1","key":"b4","series-title":"J Neurosurg Spine","first-page":"41","article-title":"Social risk factors predicting outcomes of cervical myelopathy surgery","volume":"37","author":"Rethorn ZD","year":"2022","unstructured":"Rethorn ZD, Cook CE, Park C,  Social risk factors predicting outcomes of cervical myelopathy surgery. J Neurosurg Spine. 2022;37(1):41\u201348."},{"issue":"6","key":"b5","series-title":"J Neurosurg Spine","first-page":"680","article-title":"Outcomes in socioeconomically disadvantaged patients with spinal cord injury: a systematic review","volume":"29","author":"Jorge A","year":"2018","unstructured":"Jorge A, White MD, Agarwal N. Outcomes in socioeconomically disadvantaged patients with spinal cord injury: a systematic review. J Neurosurg Spine. 2018;29(6):680\u2013686."},{"key":"b6","series-title":"World Neurosurg","first-page":"e819","article-title":"Patient education and engagement through multimedia: a prospective pilot study on health literacy in patients with cerebral aneurysms","volume":"138","author":"Agarwal N","year":"2020","unstructured":"Agarwal N, Funahashi R, Taylor T,  Patient education and engagement through multimedia: a prospective pilot study on health literacy in patients with cerebral aneurysms. World Neurosurg. 2020;138:e819\u2013e826."},{"key":"b7","series-title":"World Neurosurg","first-page":"353","article-title":"Socioeconomic implications of professional relationships within modern care delivery systems","volume":"151","author":"Agarwal N","year":"2021","unstructured":"Agarwal N, Casillo SM, Simonds G,  Socioeconomic implications of professional relationships within modern care delivery systems. World Neurosurg. 2021;151:353\u2013363."},{"issue":"5","key":"b8","series-title":"J Neurosurg Spine","first-page":"635","article-title":"Effects of preoperative obesity and psychiatric comorbidities on minimum clinically important differences for lumbar fusion in grade 1 degenerative spondylolisthesis: analysis from the prospective Quality Outcomes Database registry","volume":"33","author":"Laratta J","year":"2020","unstructured":"Laratta J, Carreon LY, Buchholz AL,  Effects of preoperative obesity and psychiatric comorbidities on minimum clinically important differences for lumbar fusion in grade 1 degenerative spondylolisthesis: analysis from the prospective Quality Outcomes Database registry. J Neurosurg Spine. 2020;33(5):635\u2013642."},{"issue":"1","key":"b9","series-title":"Neurosurg Focus","first-page":"E3","article-title":"Women fare best following surgery for degenerative lumbar spondylolisthesis: a comparison of the most and least satisfied patients utilizing data from the Quality Outcomes Database","volume":"44","author":"Chan AK","year":"2018","unstructured":"Chan AK, Bisson EF, Bydon M,  Women fare best following surgery for degenerative lumbar spondylolisthesis: a comparison of the most and least satisfied patients utilizing data from the Quality Outcomes Database. Neurosurg Focus. 2018;44(1):E3."},{"key":"b10","series-title":"World Neurosurg","first-page":"e336","article-title":"Regional variance in disability and quality-of-life outcomes after surgery for grade I degenerative lumbar spondylolisthesis: a Quality Outcomes Database analysis","volume":"138","author":"Sherrod BA","year":"2020","unstructured":"Sherrod BA, Mummaneni PV, Alvi MA,  Regional variance in disability and quality-of-life outcomes after surgery for grade I degenerative lumbar spondylolisthesis: a Quality Outcomes Database analysis. World Neurosurg. 2020;138:e336\u2013e344."},{"key":"b11","series-title":"Clin Neurol Neurosurg","first-page":"106098","article-title":"Patients with a depressive and\/or anxiety disorder can achieve optimum long term outcomes after surgery for grade 1 spondylolisthesis: analysis from the Quality Outcomes Database (QOD)","volume":"197","author":"Kashlan O","year":"2020","unstructured":"Kashlan O, Swong K, Alvi MA,  Patients with a depressive and\/or anxiety disorder can achieve optimum long term outcomes after surgery for grade 1 spondylolisthesis: analysis from the Quality Outcomes Database (QOD). Clin Neurol Neurosurg. 2020;197:106098."},{"issue":"2","key":"b12","series-title":"Neurosurgery","first-page":"200","article-title":"Sexual dysfunction: prevalence and prognosis in patients operated for degenerative lumbar spondylolisthesis","volume":"87","author":"Chan AK","year":"2020","unstructured":"Chan AK, Bisson EF, Fu KM,  Sexual dysfunction: prevalence and prognosis in patients operated for degenerative lumbar spondylolisthesis. Neurosurgery. 2020;87(2):200\u2013210."},{"issue":"3","key":"b13","series-title":"J Neurosurg Spine","first-page":"331","article-title":"Does diabetes affect outcome or reoperation rate after lumbar decompression or arthrodesis? A matched analysis of the Quality Outcomes Database data set","volume":"40","author":"Mooney J","year":"2023","unstructured":"Mooney J, Nathani KR, Zeitouni D,  Does diabetes affect outcome or reoperation rate after lumbar decompression or arthrodesis? A matched analysis of the Quality Outcomes Database data set. J Neurosurg Spine. 2023;40(3):331\u2013342."},{"issue":"3","key":"b14","series-title":"Neurosurgery","first-page":"555","article-title":"A comparison of minimally invasive and open transforaminal lumbar interbody fusion for grade 1 degenerative lumbar spondylolisthesis: an analysis of the prospective Quality Outcomes Database","volume":"87","author":"Chan AK","year":"2020","unstructured":"Chan AK, Bisson EF, Bydon M,  A comparison of minimally invasive and open transforaminal lumbar interbody fusion for grade 1 degenerative lumbar spondylolisthesis: an analysis of the prospective Quality Outcomes Database. Neurosurgery. 2020;87(3):555\u2013562."},{"issue":"5","key":"b15","series-title":"Neurosurgery","first-page":"E609","article-title":"In reply: A comparison of minimally invasive and open transforaminal lumbar interbody fusion for grade 1 degenerative lumbar spondylolisthesis: an analysis of the prospective Quality Outcomes Database","volume":"87","author":"Chan AK","year":"2020","unstructured":"Chan AK, Bission EF, Bydon M, Mummaneni PV. In reply: A comparison of minimally invasive and open transforaminal lumbar interbody fusion for grade 1 degenerative lumbar spondylolisthesis: an analysis of the prospective Quality Outcomes Database. Neurosurgery. 2020;87(5):E609\u2013E610."},{"issue":"1","key":"b16","series-title":"Neurosurgery","first-page":"80","article-title":"Obese patients benefit, but do not fare as well as nonobese patients, following lumbar spondylolisthesis surgery: an analysis of the Quality Outcomes Database","volume":"86","author":"Chan AK","year":"2020","unstructured":"Chan AK, Bisson EF, Bydon M,  Obese patients benefit, but do not fare as well as nonobese patients, following lumbar spondylolisthesis surgery: an analysis of the Quality Outcomes Database. Neurosurgery. 2020;86(1):80\u201387."},{"issue":"6","key":"b17","series-title":"Neurosurgery","first-page":"1130","article-title":"Predictors of the best outcomes following minimally invasive surgery for grade 1 degenerative lumbar spondylolisthesis","volume":"87","author":"Chan AK","year":"2020","unstructured":"Chan AK, Bisson EF, Bydon M,  Predictors of the best outcomes following minimally invasive surgery for grade 1 degenerative lumbar spondylolisthesis. Neurosurgery. 2020;87(6):1130\u20131138."},{"issue":"5","key":"b18","series-title":"Neurosurg Focus","first-page":"E13","article-title":"A comparison of minimally invasive transforaminal lumbar interbody fusion and decompression alone for degenerative lumbar spondylolisthesis","volume":"46","author":"Chan AK","year":"2019","unstructured":"Chan AK, Bisson EF, Bydon M,  A comparison of minimally invasive transforaminal lumbar interbody fusion and decompression alone for degenerative lumbar spondylolisthesis. Neurosurg Focus. 2019;46(5):E13."},{"issue":"5","key":"b19","series-title":"J Neurosurg Spine","first-page":"643","article-title":"Assessing the differences in characteristics of patients lost to follow-up at 2 years: results from the Quality Outcomes Database study on outcomes of surgery for grade I spondylolisthesis","volume":"33","author":"Bisson EF","year":"2020","unstructured":"Bisson EF, Mummaneni PV, Knightly J,  Assessing the differences in characteristics of patients lost to follow-up at 2 years: results from the Quality Outcomes Database study on outcomes of surgery for grade I spondylolisthesis. J Neurosurg Spine. 2020;33(5):643\u2013651."},{"issue":"5","key":"b20","series-title":"Neurosurg Focus","first-page":"E5","article-title":"Correlation of return to work with patient satisfaction after surgery for lumbar spondylolisthesis: an analysis of the Quality Outcomes Database","volume":"48","author":"DiGiorgio AM","year":"2020","unstructured":"DiGiorgio AM, Mummaneni PV, Park P,  Correlation of return to work with patient satisfaction after surgery for lumbar spondylolisthesis: an analysis of the Quality Outcomes Database. Neurosurg Focus. 2020;48(5):E5."},{"issue":"1","key":"b21","series-title":"Neurosurg Focus","first-page":"E2","article-title":"Defining the minimum clinically important difference for grade I degenerative lumbar spondylolisthesis: insights from the Quality Outcomes Database","volume":"44","author":"Asher AL","year":"2018","unstructured":"Asher AL, Kerezoudis P, Mummaneni PV,  Defining the minimum clinically important difference for grade I degenerative lumbar spondylolisthesis: insights from the Quality Outcomes Database. Neurosurg Focus. 2018;44(1):E2."},{"issue":"6","key":"b22","series-title":"Neurosurg Focus","first-page":"E7","article-title":"Developing nonlinear k-nearest neighbors classification algorithms to identify patients at high risk of increased length of hospital stay following spine surgery","volume":"54","author":"Shahrestani S","year":"2023","unstructured":"Shahrestani S, Chan AK, Bisson EF,  Developing nonlinear k-nearest neighbors classification algorithms to identify patients at high risk of increased length of hospital stay following spine surgery. Neurosurg Focus. 2023;54(6):E7."},{"issue":"2","key":"b23","series-title":"Neurosurg Focus","first-page":"E11","article-title":"Minimally invasive versus open fusion for Grade I degenerative lumbar spondylolisthesis: analysis of the Quality Outcomes Database","volume":"43","author":"Mummaneni PV","year":"2017","unstructured":"Mummaneni PV, Bisson EF, Kerezoudis P,  Minimally invasive versus open fusion for Grade I degenerative lumbar spondylolisthesis: analysis of the Quality Outcomes Database. Neurosurg Focus. 2017;43(2):E11."},{"issue":"1","key":"b24","series-title":"Neurosurg Focus","first-page":"E2","article-title":"Minimally invasive versus open transforaminal lumbar interbody fusion for grade I lumbar spondylolisthesis: 5-year follow-up from the prospective multicenter Quality Outcomes Database registry","volume":"54","author":"Chan AK","year":"2023","unstructured":"Chan AK, Bydon M, Bisson EF,  Minimally invasive versus open transforaminal lumbar interbody fusion for grade I lumbar spondylolisthesis: 5-year follow-up from the prospective multicenter Quality Outcomes Database registry. Neurosurg Focus. 2023;54(1):E2."},{"issue":"5","key":"b25","series-title":"Neurosurg Focus","first-page":"E12","article-title":"Predictive model for long-term patient satisfaction after surgery for grade I degenerative lumbar spondylolisthesis: insights from the Quality Outcomes Database","volume":"46","author":"Mummaneni PV","year":"2019","unstructured":"Mummaneni PV, Bydon M, Alvi MA,  Predictive model for long-term patient satisfaction after surgery for grade I degenerative lumbar spondylolisthesis: insights from the Quality Outcomes Database. Neurosurg Focus. 2019;46(5):E12."},{"issue":"12","key":"b26","series-title":"Spine (Phila Pa 1976)","first-page":"836","article-title":"\"July Effect\" revisited: july surgeries at residency training programs are associated with equivalent long-term clinical outcomes following lumbar spondylolisthesis surgery","volume":"46","author":"Chan AK","year":"2021","unstructured":"Chan AK, Patel AB, Bisson EF,  \"July Effect\" revisited: july surgeries at residency training programs are associated with equivalent long-term clinical outcomes following lumbar spondylolisthesis surgery. Spine (Phila Pa 1976). 2021;46(12):836\u2013843."},{"issue":"14","key":"b27","series-title":"Spine (Phila Pa 1976)","first-page":"1000","article-title":"Outcomes and complications with age in spondylolisthesis: an evaluation of the elderly from the Quality Outcomes Database","volume":"45","author":"Karsy M","year":"2020","unstructured":"Karsy M, Chan AK, Mummaneni PV,  Outcomes and complications with age in spondylolisthesis: an evaluation of the elderly from the Quality Outcomes Database. Spine (Phila Pa 1976). 2020;45(14):1000\u20131008."},{"key":"b28","series-title":"World Neurosurg","first-page":"e1024","article-title":"Inferior clinical outcomes for patients with Medicaid insurance after surgery for degenerative lumbar spondylolisthesis: a prospective registry analysis of 608 patients","volume":"164","author":"Chan AK","year":"2022","unstructured":"Chan AK, Letchuman V, Mummaneni PV,  Inferior clinical outcomes for patients with Medicaid insurance after surgery for degenerative lumbar spondylolisthesis: a prospective registry analysis of 608 patients. World Neurosurg. 2022;164:e1024\u2013e1033."},{"issue":"6","key":"b29","series-title":"J Neurosurg Spine","first-page":"883","article-title":"The association of patient education level with outcomes after elective lumbar surgery: a Michigan Spine Surgery Improvement Collaborative study","volume":"36","author":"Hamilton T","year":"2021","unstructured":"Hamilton T, Macki M, Oh SY,  The association of patient education level with outcomes after elective lumbar surgery: a Michigan Spine Surgery Improvement Collaborative study. J Neurosurg Spine. 2021;36(6):883\u2013891."},{"issue":"5","key":"b30","series-title":"World Neurosurg","first-page":"1223","article-title":"Educational resources \"over the head\" of neurosurgical patients: the economic impact of inadequate health literacy","volume":"84","author":"Agarwal N","year":"2015","unstructured":"Agarwal N, Shah K, Stone JG, Ricks CB, Friedlander RM. Educational resources \"over the head\" of neurosurgical patients: the economic impact of inadequate health literacy. World Neurosurg. 2015;84(5):1223\u20131226."},{"issue":"1","key":"b31","series-title":"Health Lit Res Pract","first-page":"e46","article-title":"Health literacy in surgery","volume":"4","author":"Chang ME","year":"2020","unstructured":"Chang ME, Baker SJ, Dos Santos Marques IC,  Health literacy in surgery. Health Lit Res Pract. 2020;4(1):e46\u2013e65."},{"issue":"26","key":"b32","series-title":"Spine (Phila Pa 1976)","first-page":"2324","article-title":"Lumbar disc herniation in the Spine Patient Outcomes Research Trial: does educational attainment impact outcome?","volume":"36","author":"Olson PR","year":"2011","unstructured":"Olson PR, Lurie JD, Frymoyer J,  Lumbar disc herniation in the Spine Patient Outcomes Research Trial: does educational attainment impact outcome? Spine (Phila Pa 1976). 2011;36(26):2324\u20132332."},{"issue":"1","key":"b33","series-title":"BMC Health Serv Res","first-page":"394","article-title":"The role of health literacy in explaining the association between educational attainment and the use of out-of-hours primary care services in chronically ill people: a survey study","volume":"18","author":"Jansen T","year":"2018","unstructured":"Jansen T, Rademakers J, Waverijn G, Verheij R, Osborne R, Heijmans M. The role of health literacy in explaining the association between educational attainment and the use of out-of-hours primary care services in chronically ill people: a survey study. BMC Health Serv Res. 2018;18(1):394."},{"key":"b34","series-title":"Clin Neurol Neurosurg","first-page":"106141","article-title":"Health literacy among neurosurgery and other surgical subspecialties: readability of online patient materials found with Google","volume":"197","author":"Behmer Hansen R","year":"2020","unstructured":"Behmer Hansen R, Gold J, Lad M, Gupta R, Ganapa S, Mammis A. Health literacy among neurosurgery and other surgical subspecialties: readability of online patient materials found with Google. Clin Neurol Neurosurg. 2020;197:106141."},{"key":"b35","series-title":"World Neurosurg","first-page":"202","article-title":"Patient education in neurosurgery: part 1 of a systematic review","volume":"147","author":"Shlobin NA","year":"2021","unstructured":"Shlobin NA, Clark JR, Hoffman SC, Hopkins BS, Kesavabhotla K, Dahdaleh NS. Patient education in neurosurgery: part 1 of a systematic review. World Neurosurg. 2021;147:202\u2013214.e1."},{"issue":"4","key":"b36","series-title":"J Neurosurg Spine","first-page":"370","article-title":"An analysis from the Quality Outcomes Database, Part 2. Predictive model for return to work after elective surgery for lumbar degenerative disease","volume":"27","author":"Asher AL","year":"2017","unstructured":"Asher AL, Devin CJ, Archer KR,  An analysis from the Quality Outcomes Database, Part 2. Predictive model for return to work after elective surgery for lumbar degenerative disease. J Neurosurg Spine. 2017;27(4):370\u2013381."},{"key":"b37","series-title":"US Department of Education","article-title":"The Health Literacy of America\u2019s Adults: Results from the 2003 National Assessment of Adult Literacy. NCES 2006-483","author":"Kutner M","year":"2006","unstructured":"Kutner M, Greenburg E, Jin Y, Paulsen C. The Health Literacy of America\u2019s Adults: Results from the 2003 National Assessment of Adult Literacy. NCES 2006-483. US Department of Education; 2006. Accessed April 1, 2024. https:\/\/nces.ed.gov\/pubs2006\/2006483.pdf"},{"issue":"12","key":"b38","series-title":"J Clin Neurosci","first-page":"2179","article-title":"Comparison of neurological healthcare oriented educational resources for patients on the internet","volume":"21","author":"Punia V","year":"2014","unstructured":"Punia V, Dagar A, Agarwal N, He W, Hillen M. Comparison of neurological healthcare oriented educational resources for patients on the internet. J Clin Neurosci. 2014;21(12):2179\u20132183."},{"issue":"1","key":"b39","series-title":"AJR Am J Roentgenol","first-page":"111","article-title":"Health literacy and online educational resources: an opportunity to educate patients","volume":"204","author":"Hansberry DR","year":"2015","unstructured":"Hansberry DR, Agarwal N, Baker SR. Health literacy and online educational resources: an opportunity to educate patients. AJR Am J Roentgenol. 2015;204(1):111\u2013116."},{"issue":"2","key":"b40","series-title":"J Nucl Med Technol","first-page":"144","article-title":"Nuclear medicine and resources for patients: how complex are online patient educational materials?","volume":"46","author":"Hansberry DR","year":"2018","unstructured":"Hansberry DR, Shah K, Agarwal N, Kim SM, Intenzo CM. Nuclear medicine and resources for patients: how complex are online patient educational materials? J Nucl Med Technol. 2018;46(2):144\u2013146."},{"issue":"4","key":"b41","series-title":"Cardiovasc Intervent Radiol","first-page":"1034","article-title":"Health literacy in vascular and interventional radiology: a comparative analysis of online patient education resources","volume":"37","author":"Hansberry DR","year":"2014","unstructured":"Hansberry DR, Kraus C, Agarwal N, Baker SR, Gonzales SF. Health literacy in vascular and interventional radiology: a comparative analysis of online patient education resources. Cardiovasc Intervent Radiol. 2014;37(4):1034\u20131040."},{"key":"b42","series-title":"Education and the Prevalence of Pain","author":"Atlas SJ","year":"2009","unstructured":"Atlas SJ, Skinner J. Education and the Prevalence of Pain. Working Paper l4964. National Bureau of Economic Research; 2009. Accessed April 1, 2024. https:\/\/www.nber.org\/system\/files\/working_papers\/w14964\/w14964.pdf"},{"issue":"7","key":"b43","series-title":"Spine (Phila Pa 1976)","first-page":"806","article-title":"Descriptive epidemiology and prior healthcare utilization of patients in the Spine Patient Outcomes Research Trial\u2019s (SPORT) three observational cohorts: disc herniation, spinal stenosis, and degenerative spondylolisthesis","volume":"31","author":"Cummins J","year":"2006","unstructured":"Cummins J, Lurie JD, Tosteson TD,  Descriptive epidemiology and prior healthcare utilization of patients in the Spine Patient Outcomes Research Trial\u2019s (SPORT) three observational cohorts: disc herniation, spinal stenosis, and degenerative spondylolisthesis. Spine (Phila Pa 1976). 2006;31(7):806\u2013814."},{"issue":"1","key":"b44","series-title":"J Neurosurg Spine","first-page":"60","article-title":"Education level as a prognostic indicator at 12 months following decompression surgery for symptomatic lumbar spinal stenosis","volume":"30","author":"Elsayed GA","year":"2018","unstructured":"Elsayed GA, Dup\u00e9p\u00e9 EB, Erwood MS,  Education level as a prognostic indicator at 12 months following decompression surgery for symptomatic lumbar spinal stenosis. J Neurosurg Spine. 2018;30(1):60\u201368."},{"issue":"6","key":"b45","series-title":"J Neurosurg","first-page":"1757","article-title":"Research using the Quality Outcomes Database: accomplishments and future steps toward higher-quality real-world evidence","volume":"139","author":"Asher AL","year":"2023","unstructured":"Asher AL, Haid RW, Stroink AR,  Research using the Quality Outcomes Database: accomplishments and future steps toward higher-quality real-world evidence. J Neurosurg. 2023;139(6):1757\u20131775."}],"container-title":["Journal of Neurosurgery: Spine"],"original-title":[],"link":[{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg-spine\/41\/3\/article-p341.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg-spine\/41\/3\/article-p341.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg-spine\/41\/3\/article-p341.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,12,6]],"date-time":"2024-12-06T13:18:32Z","timestamp":1733491112000},"score":1,"resource":{"primary":{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg-spine\/41\/3\/article-p341.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,9,1]]},"references-count":45,"journal-issue":{"issue":"3"},"URL":"https:\/\/doi.org\/10.3171\/2024.3.spine231024","relation":{},"ISSN":["1547-5654"],"issn-type":[{"value":"1547-5654","type":"print"}],"subject":[],"published":{"date-parts":[[2024,9,1]]}}}