# ‘Before and After’. The Journey of Patients With Low Back Pain Consulting in Elective Spine Surgery Clinics. A Qualitative Study Protocol

## TL;DR

This study explores the experiences of low back pain patients who consult in elective spine surgery clinics but are not offered surgery, aiming to improve their care journey and communication.

## Contribution

The study introduces a qualitative approach to identify gaps in care and expectations for non-surgical LBP patients in elective spine clinics.

## Key findings

- Themes will emerge from patient interviews to highlight care journey gaps.
- Findings may inform new educational resources and communication strategies for non-surgical LBP management.
- Patient and public involvement will ensure interview questions reflect real patient experiences.

## Abstract

Low back pain (LBP) is a highly prevalent and disabling condition. People with LBP may be referred to elective surgical clinics for further evaluation and consideration of surgery. Despite long waits for an initial appointment, many of these patients are not surgical candidates and may be discharged, receiving minimal‐to‐no care, advice or alternative treatment options, leaving a critical gap in care.

Approximately 25 participants with dominant, chronic non‐specific axial LBP who are (1) referred to and (2) discharged without spinal surgery following consultation in two elective spinal surgery clinics in Western Australia will participate in a one‐on‐one pre‐consultation semi‐structured interview and a similar post‐consultation qualitative interview. Purposive sampling will be used to recruit participants. Interviews will be audio‐recorded and transcribed, underpinned by a qualitative descriptive approach to explore participants' care journey, including pre‐consultation expectations and overall experiences post‐consultation. We will use inductive content analysis to analyse our data, allowing for the identification of themes that are generated from the participants' responses.

This protocol outlines the methodological process for a qualitative study exploring the experiences and expectations of LBP patients before and after consulting in elective spinal surgery clinics in Western Australia. The findings may give rise to consumer‐focused solutions to improve the care journey and highlight gaps in patient expectations and understanding of non‐surgical management, informing the development of tailored educational resources, communication strategies and new care pathways.

This study will incorporate patient and/or public involvement by engaging representatives from Musculoskeletal Australia (https://muscha.org/) to contribute to the study design and interpretation of findings. Specifically, a consumer with lived experience of low back pain will be invited to review and provide feedback on the semi‐structured interview questions, to ensure they are appropriate, accessible and reflective of patient experiences.

This study is not a clinical trial and is therefore not registered.