Readability of the Most Commonly Accessed Online Patient Education Materials Pertaining to Surgical Treatments of the Spine

OBJECTIVE: The American Medical Association and National Institutes of Health have recommended that patient education materials should be written at the sixth grade reading level to maximize patient comprehension. The objective of the present study was to evaluate the readability of Internet information for the 9 most common spinal surgeries. METHODS: We reviewed 90 online patient educational materials regarding the 9 most common spinal surgeries as reported by the North American Spine Society. A Google search was performed on March 23, 2019 for each surgery, and the top 10 most visited websites for each surgery were assessed for reading level using the Flesch-Kincaid formula. RESULTS: Using the Flesch-Kincaid formula, the average grade reading level of the 90 websites included was 12.82, with a reading ease of 37.04 ("difficult college"). Only 6 websites relayed information to patients at or below the national average of an eighth-grade reading level. The websites for bone morphogenic protein had the highest average grade reading level at 15.88 +/- 2.6. Lumbar microscopic discectomy had the lowest average grade reading level at 10.37 +/- 2.89. All surgical options discussed had an average readability above the recommended sixth grade reading level. CONCLUSIONS: The most accessed online materials for common spinal surgeries, not only exceeded the readability limits recommended by both the American Medical Association and the National Institutes of Health, but they also exceeded the average reading ability of most adults in the United States. Patients, therefore, might not fully comprehend the information from commonly accessed websites regarding surgical spine treatment options.