Implications of Tomophobia and Tomophilia for Clinical Practice: Understanding Patient Attitudes Toward Spine Surgery.

Advances in spine surgery have dramatically improved safety and precision, yet patient perceptions of surgery now span two psychological extremes: tomophobia, an irrational fear of surgical intervention, and tomophilia, an excessive enthusiasm for operative solutions. This conceptual review explores their historical roots, psychosocial drivers, and clinical implications. Tomophobia leads to treatment avoidance and anxiety, while tomophilia fosters overutilization and surgery beyond indication. Addressing both requires balancing empathy with evidence, emphasizing patient education, and reinforcing ethical decision-making. Recognizing these attitudes can help clinicians navigate the psychological dimension of surgical consent and promote truly patient-centered spine care.