International Journal of Science, Engineering and TechnologyAuthors: Research Scholar Badal Biswas, Associate Professor Dr. Jagat Bahadur Rawat
Abstract: For patients with lumbar nerve root compression and radiculopathy, the choice between decompression and continued conservative care is preference-sensitive: both are reasonable, and the better option depends on how a patient weighs speed of relief against surgical risk. Yet decisions are often recorded only as consent, and outcomes after surgery are seldom measured in a way that patients recognise. This paper proposes a patient-centred framework that links a structured shared decision-making step, based on the three-talk model, with routine monitoring of patient-reported outcomes. The decision step records the options discussed, the patient’s goals in their own words and the decision reached. Outcomes are measured with the Oswestry Disability Index, pain ratings, walking capacity, the EQ-5D-5L and goal attainment at baseline, 6 weeks and 3, 6 and 12 months. Responders are defined as improving by at least 10 points or 30% on the Oswestry Disability Index; the 30% criterion is the stricter of the two for patients whose baseline score exceeds about 33. The framework is a design contribution derived from a doctoral thesis and reports no patient data.
