Autonomy with responsibility: is informed consent just a signature on a paper? Evaluation in patients who underwent spine surgery

Autonomy with responsibility: is informed consent just a signature on a paper? Evaluation in patients who underwent spine surgery
Jorge H. Nuñez Camarena, David Bosch Garcia, Berta Escudero
The Spine Journal, September 2023; 23(9)
Abstract
Background Context
Despite the relevance of informed consent in spine surgery, and all type of surgeries, and its daily use, there are very few studies that have checked if this document really accomplishes its duty.
Purpose
The aim of this study is to evaluate the real information that patients who went under spine surgery receive and know, after signing the informed consent.
Study Design/Setting
Retrospective study.
Patient Sample
Patients who underwent spine arthrodesis or spine discectomy between 2017 and 2019 were analyzed. Surgical technique and risks were explained before they were accepted to be on the surgery waiting list. They were given a copy of the informed consent.
Outcome Measures
Within the studied variables, we have asked patients if they have read the informed consent before surgery, if they could recall the surgical technique, spinal segment operated (cervical, thoracic, or lumbar) and vertebral levels operated. We added if they knew about surgical risks and if they looked for information about their procedure from other sources.
Methods
Answers were analyzed by age and educational level.
Results
From 458 total patients, only 51.9% of them answered all the questions. Also, 63% of patients agreed to have read the informed consent before surgery; 91.6% of patients knew about the spine segment operated; however, only 73.5% of patients remembered the surgical technique and 63.9% of patients could recall the vertebral levels. In addition, 39.1% of patients did not know about surgical risks and only 16.0% of patients mentioned to have looked for additional information using other sources. A significant statistical result was obtained between the search of additional information and younger patients (p < 0.001) and superior educational formation (p = 0.023).
Conclusions
Even though informed consent is an important procedure to get patients informed before spinal surgery, almost 40% of our patients underwent surgery without reading this document and not being aware of surgical risks.