Spine Surgery and Related Research
Online ISSN : 2432-261X
ISSN-L : 2432-261X
ORIGINAL ARTICLE
Readability of Online Patient Education Materials for Endoscopic Spine Surgery
Matthew MeadeMark MillerRuchir NanavatiWilliam DiCiurcioManeesha PalakurthiVictor HsuMark F. KurdI. David KayeGregory D. SchroederChristopher KeplerBarrett Woods
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JOURNAL OPEN ACCESS

2026 Volume 10 Issue 2 Pages 204-210

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Abstract

Introduction: Patients frequently use internet-based resources to seek information. Endoscopic spine surgery is extensively marketed on the internet, with purported benefits over traditional open techniques. Previous literature has recommended that the readability of patient education materials (PEM) should not exceed the 6th-grade reading level to optimize health literacy. This study aims to evaluate the readability of online PEMs concerning endoscopic spine surgery.

Methods: A Google search query was performed using the term "Endoscopic spine surgery patient information." The first 25 websites meeting study inclusion criteria were analyzed for readability using Flesch-Kincaid, average reading level consensus, Gunning Fog, Coleman-Liau, SMOG, and Linsear Write indices. Descriptive statistics were reported.

Results: The mean average reading level was 12.8 (1.68). The mean Flesch-Kincaid Reading Ease score was 37.6 (11.1). The mean Gunning Fog Score was 14.7 (1.92), Flesch-Kincaid grade level was 12.2 (2.56), Coleman-Liau was 14.0 (1.82), SMOG 11.6 (2.07), Automated Readability Index was 12.9 (3.11), and Linsear Write was 11.8 (2.21). Zero of the 25 included PEMs was evaluated to be below the recommended sixth-grade reading level. Four of the PEMs were considered General Health Information, and 21 were considered Clinical Practice. No differences were found between Clinical Practice and General Health Information websites (p>0.05).

Conclusions: Creating appropriate PEMs is integral to achieving optimal health literacy. The current readability of the most accessible PEMs related to endoscopic spine surgery is inadequate. As it stands, many patients may not appropriately comprehend the description of their anticipated surgery.

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© 2026 The Japanese Society for Spine Surgery and Related Research.

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