Background: Patients’ perspectives are central measures of success in health care delivery. The association of postoperative changes in patient-reported outcome measures (PROM) and expectation fulfillment is not well established.

Purpose: This study's primary objective was to assess the association between changes in PROMs (eg, ODI or EQ-5D) and patient multidimensional expectations fulfillment at one year following elective lumbar spine surgery. The secondary objectives included measuring changes in PROMs across various levels of expectation fulfillment and identifying the PROM instrument that explains the highest variability in each expectation domain.

Study Design: Retrospective cohort study from the prospectively collected registry data. Patient sample: Data were obtained from the Canadian Spine Outcome Research Network (CSORN) registry, which prospectively enrolls adults undergoing elective spine surgery in Canada. We included adults who underwent elective lumbar spine surgery between January 2015 and December 2022.

Outcome Measures: The study's primary outcome was the extent of expectation fulfillment at one-year follow-up in surgical patients.

Methods: Demographic, lifestyle, clinical, and multidimensional expectation data were collected using the North American Spine Society Lumbar Spine Questionnaire. Postoperative changes in PROMs were the primary exposure variables. Baseline sociodemographic and clinical characteristics were summarized descriptively, and ordinal logistic regression was used to examine associations between expectation fulfillment and changes in PROMs, adjusting for confounders.