Aust Health Rev. 2025 Dec 4;49(6):AH25242. doi: 10.1071/AH25242.
ABSTRACT
OBJECTIVE: Spinal surgery rates in Australia continue to rise despite limited evidence for their effectiveness in managing uncomplicated chronic back pain. This study examined patient-level factors that influence willingness to undergo surgery, to informing future work promoting non-surgical care pathways.
METHODS: We conducted a cross-sectional online survey in March 2025 of 152 privately insured Australian adults with chronic low back pain. Participants reported pain characteristics, functional interference, prior imaging and pain-related beliefs (expectations of recovery, self-efficacy and catastrophising). Willingness to undergo spinal surgery within 5 years was assessed on a 5-point scale, and dichotomised into ‘willing’ (3-4) and ‘unwilling’ (0-1); respondents answering ‘unsure’ were excluded. Logistic regression examined predictors of willingness to consider surgery.
RESULTS: Of 152 participants (mean age 59.3 years, 64% female), 24% expressed willingness to undergo surgery. Negative pain beliefs, higher pain intensity and younger age significantly predicted willingness, with the strongest effect seen for negative pain beliefs (OR 2.62, 95% CI 1.16-5.92, P = 0.02). Functional interference, imaging history and gender showed positive, but non-significant, associations.
CONCLUSION: Negative pain beliefs predict willingness to undergo spinal surgery. This finding has important policy implications, suggesting that addressing belief-driven demand may help reduce the economic burden of surgery by directing patients towards guideline-based, high-value, non-surgical care.
PMID:41297063 | DOI:10.1071/AH25242
