Background: The drivers for satisfaction of patients after spinal surgeries are largely unknown and potentially responsive to non-medical factors. We investigated medical and non-medical drivers for patient satisfaction and fulfillment of expectations after spinal surgery.

Methods: We performed a questionnaire-based postoperative survey from May-December 2021. Overall, 400 questionnaires were sent within 3 to 6 weeks after adult spine surgery. The survey contained 33 variables (basic demographic (n = 6), health state (n = 6), satisfaction with change after spine surgery (n = 5), and satisfaction with non-medical (n = 9) variables. The primary outcome was global satisfaction of change after spinal surgery (>50th percentile of question).

Results: The return rate of questionnaires was 42% (n = 167). The internal consistency of the questionnaire was acceptable (Cronbach's alpha 0.59 [range 0.49-0.68]). The current health and satisfaction with change of current health after spine surgery showed mostly strong correlations (mobility: rho 0.67; self-care: 0.74; usual activities: 0.73; pain: 0.73; anxiety: 0.79; p < 0.001 each). Pain was most commonly ranked as the most important factor for satisfaction (n = 56 [58%]), mobility as second (n = 42 [43%]), and friendliness as third (n = 27 [28%]) most important. Surprisingly, radiological proof of successful surgery was most commonly ranked last (n = 51 [53%]]. Patients with fulfillment of their expectations were more likely to have been satisfied with mobility after spine surgery (odds ratio 2.2 [95% Confidence Interval (CI]] 1.3-3.7) and friendliness of the surgeon (1.8 [95% CI 1.1-2.8)].

Conclusion: Aside from the known medical driver, mobility, for satisfaction and fulfillment of patient’s expectations, friendliness of the surgeon is shown to play an important role. Surprisingly, other non-medical factors, such as patient’s knowledge about radiological proof of successful surgery, the role of nurses and guest relations did not play an important role in this patient cohort.