Comparison of the EuroQOL-5D With the Oswestry Disability Index, Back and Leg Pain Scores in Patients With Degenerative Lumbar Spine Pathology

Background:Degenerative spine pathology is a common reason for consultation in rheumatology. The lumbar spine is the first seat.Objectives:To determine the epidemiological and semiological profile of degenerative lumbar spine damage in Kara.Methods:It was a cross-sectional study based on patient records who had consulted for a degenerative lumbar spine pathology in the rheumatology department of the CHU-Kara (Northen Togo) over a three-year period.Results:Of the 1,767 patients examined during the study period, 745 (42.16%) suffered from a degenerative pathology of lumbar spine. They were 285 men (38.3%), and 460 women (61.7%) H/F ratio of 0.62. Traders (30%), civil servants (12.5%), teachers (9.5%), and housewives (8.7%) were the most affected occupational categories. The average age of patients at the consultation was 50.6 ± 12.3 years, and the average duration of disease progression was 4.3 years ± 1.8 years. The clinical forms of degenerative lumbar spine damage were: common low back pain (194 cases; 26.04%), common lomboradiculalgia by probable disco-radicular conflict (457 cases; 61.34%) and the narrowed lumbar canal (94 cases; 12.62%). Common low back pain was acute in 56.7% of cases. The path of radiculalgia during the probable herniated disc was truncated in 19.2% of cases, L5 in 46.4% of cases, S1 in 32.9% of cases, and L4 in 2.7% of cases. The walking perimeter was less than 500 meters in 48% of patients with narrowed lumbar canal. Signs of degenerative disc disease (536 cases), spondylolisthesis (102 cases) and isthmic lysis (37 cases) were the main radiological lesions observed.Conclusion:Degenerative damage to lumbar spine is dominated in North Togo by common lomboradiculalgia by probable herniated disc.References:[1]Mijiyawa M, Oniankitan O, Kolani B, Koriko T. La lombalgie en consultation hospitalière à Lomé (Togo). Rev Rhum 2000;67:914-20.[2]Louw QA, Morris LD, Grimmer-Somers K. The prevalence of low back pain in Africa: a systematic review. BMC Musculoskelet Disord 2007;8:105.[3]Morris LD, Daniels KJ, Ganguli B, Louw QA. An update on the prevalence of low back pain in Africa: a systematic review and meta-analyses. BMC Musculoskelet Disord 2018;19:196.[4]Ouédraogo D-D, Ntsiba H, Tiendrébéogo Zabsonré J, Tiéno H, Bokossa LIF, Kaboré F, et al. Clinical spectrum of rheumatologic diseases in a department of rheumatology in Ouagadougou (Burkina Faso). Clin Rheumatol 2014;33:385-9.Disclosure of Interests:None declared

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Severe Atrophy of the Ipsilateral Psoas Muscle Associated with Hip Osteoarthritis and Spinal Stenosis—A Case Report

Medicina ◽

10.3390/medicina57010073 ◽

2021 ◽

Vol 57 (1) ◽

pp. 73

Author(s):

Byeongcheol Lee ◽

Sang Eun Lee ◽

Yong Han Kim ◽

Jae Hong Park ◽

Ki Hwa Lee ◽

...

Keyword(s):

Lumbar Spine ◽

Spinal Stenosis ◽

Hip Osteoarthritis ◽

Psoas Muscle ◽

The Elderly ◽

Leg Pain ◽

Spine Pathology ◽

Lumbar Mri ◽

Physical Examinations ◽

Clinical Clue

Pathology of the lumbar spine and hip joint can commonly coexist in the elderly. Anterior and lateral leg pain as symptoms of hip osteoarthritis and spinal stenosis can closely resemble each other, with only subtle differences in both history and physical examinations. It is not easy to identify the origin of this kind of hip pain. The possibility of hip osteoarthritis should not be underestimated, as this could lead to an incorrect diagnosis and inappropriate spinal surgery. We report the case of a 54-year-old female with chronic right anterior and lateral leg pain who did not respond to repeated spinal blocks based on lumbar MRI, but in whom hip osteoarthritis was considered since severe atrophy of the ipsilateral psoas muscle was identified. We suggest that severe psoas muscle atrophy can be a clinical clue to identify hip osteoarthritis and is related to lower extremity pain, even if there is a coexisting lumbar spine pathology.

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RISK FACTORS OF PEDICLE FIXATION INSTABILITY AT PATIENTS WITH DEGENERATIVE LUMBAR SPINE PATHOLOGY

Bulletin of Siberian Medicine ◽

10.20538/1682-0363-2016-2-13-19 ◽

2016 ◽

Vol 15 (2) ◽

pp. 13-19

Author(s):

A. E. Bokov ◽

S. G. Mlyavykh ◽

A. Ya. Aleynik ◽

A. A. Bulkin ◽

M. V. Rasteryaeva

Keyword(s):

Risk Factors ◽

Lumbar Spine ◽

Degenerative Lumbar Spine ◽

Pedicle Fixation ◽

Spine Pathology

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Assessment of the Minimum Clinically Important Difference in the Timed Up and Go Test After Surgery for Lumbar Degenerative Disc Disease

Neurosurgery ◽

10.1227/neu.0000000000001320 ◽

2017 ◽

Vol 80 (3) ◽

pp. 380-385 ◽

Cited By ~ 43

Author(s):

Oliver P. Gautschi ◽

Martin N. Stienen ◽

Marco V. Corniola ◽

Holger Joswig ◽

Karl Schaller ◽

...

Keyword(s):

Oswestry Disability Index ◽

Short Form ◽

Minimum Clinically Important Difference ◽

Leg Pain ◽

Analog Scale ◽

Disc Disease ◽

Timed Up And Go ◽

Minimum Detectable Change ◽

Clinically Important Difference ◽

Euroqol 5D

Abstract BACKGROUND: The Timed Up and Go Test (TUG Test) has previously been described as a reliable tool to evaluate objective functional impairment in patients with degenerative disc disease. OBJECTIVE: The aim of this study was to assess the minimum clinically important difference (MCID) of the TUG Test. METHODS: The TUG Test (measured in seconds) was correlated with validated patient-reported outcome measures (PROs) of pain intensity (Visual Analog Scale for back and leg pain), functional impairment (Oswestry Disability Index, Roland Morris Disability Index), and health-related quality of life measures (Short Form-12 and EuroQol 5D). Three established methods were used to establish anchor-based MCID values using responders of the following PROs (Visual Analog Scale back and leg pain, Oswestry Disability Index, Roland Morris Disability Index, EuroQol 5D index, and Short Form-12 Physical Component Summary) as anchors: (1) average change, (2) minimum detectable change, and (3) change difference approach. RESULTS: One hundred patients with a mean ± SD age of 56.2 ± 16.1 years, 57 (57%) male, 45 patients undergoing microdiscectomy, 35 undergoing lumbar decompression, and 20 undergoing fusion surgery were studied. The 3 MCID computation methods revealed a range of MCID values according to the PRO used from 0.9 s (Oswestry Disability Index based on the change difference approach) to 6.0 s (EuroQol 5D index based on the minimum detectable change approach), with a mean MCID of 3.4 s for all measured PROs. CONCLUSION: The MCID for the TUG Test time is highly variable depending on the computation technique used. The average TUG Test MCID was 3.4 s using all 3 methods and all anchors.

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Spine surgery referrals redirected through a multidisciplinary care pathway: effects of nonsurgeon triage including MRI utilization

Journal of Neurosurgery Spine ◽

10.3171/2013.10.spine13434 ◽

2014 ◽

Vol 20 (1) ◽

pp. 87-92 ◽

Cited By ~ 17

Author(s):

Danica R. Kindrachuk ◽

Daryl R. Fourney

Keyword(s):

Spine Surgery ◽

Oswestry Disability Index ◽

Leg Pain ◽

Low Back ◽

Implementation Study ◽

Early Implementation ◽

Euroqol 5D ◽

Group A ◽

Group B ◽

Spine Surgeon

Object The Saskatchewan Spine Pathway (SSP) was introduced to improve quality and access to care for patients with low-back and leg pain in the province. There is very limited data regarding the efficacy of nonsurgeon triage of surgical referrals. The objective of this early implementation study was to determine how the SSP affects utilization of MRI and spine surgery. Methods The authors performed a retrospective analysis of 87 consecutive patients with low-back and leg pain who were initially referred to a spine surgeon but were instead redirected to the SSP clinic between May 1, 2011, and November 30, 2011. The SSP clinic triaged patients into 2 groups: Group A (nonsurgical management) and Group B (referred back to the spine surgeon). The SSP classification was modified from the classification proposed by Hall et al. Pain and disability were scored by pain-related visual analog scale, modified Oswestry Disability Index, and EuroQol-5D. Results Sixty-two patients (Group A, 71.3%) were discharged after patient education, self-care advice, and/or referral for additional mechanical therapies. Although only 25 patients (Group B, 28.7%) were directed back to the surgeon, the final percentage (12.6%) offered surgery was similar to that of historic controls (15%). Total MRI utilization was significantly lower in Group A (25.8%) than Group B (92.0%) (p < 0.0001). Nonsurgeon triage captured all red flags detected by the surgeon. Patients in Group B were much more likely to have a leg-dominant pain (p = 0.0088) and had significantly higher Oswestry Disability Index (p = 0.0121) and EuroQol-5D mobility (p = 0.0484) scores. Conclusions The SSP significantly reduced MRI utilization and referrals seen by the surgeon for nonoperative care. Although this early implementation study suggests potential for cost savings, a more rigorous analysis of outcomes, costs, and patient satisfaction is required.

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Letter to the Editor. Reappraising role of clinical evaluations in degenerative lumbar spine pathologies

Journal of Neurosurgery Spine ◽

10.3171/2018.10.spine181282 ◽

2019 ◽

Vol 30 (6) ◽

pp. 860-861 ◽

Cited By ~ 1

Author(s):

Sunil Munakomi

Keyword(s):

Lumbar Spine ◽

Clinical Evaluations ◽

Degenerative Lumbar Spine ◽

Letter To The Editor

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Do Orthopedic Surgeons or Neurosurgeons Detect More Hip Disorders in Patients with Hip-Spine Syndrome? A Nationwide Database Study

Brain Sciences ◽

10.3390/brainsci11040485 ◽

2021 ◽

Vol 11 (4) ◽

pp. 485

Author(s):

Tsung-Cheng Yin ◽

Adam M. Wegner ◽

Meng-Ling Lu ◽

Yao-Hsu Yang ◽

Yao-Chin Wang ◽

...

Keyword(s):

Lumbar Spine ◽

Spine Surgery ◽

Hip Surgery ◽

Lumbar Spine Surgery ◽

Research Database ◽

X Rays ◽

Replacement Surgery ◽

Orthopedic Surgeons ◽

Spine Pathology ◽

Sh Group

Background: Disorders of the hip and lumbar spine can create similar patterns of pain and dysfunction. It is unknown whether all surgeons, regardless of orthopedic or neurosurgery training, investigate and diagnose concurrent hip and spine pathology at the same rate. Methods: Data were retrieved from Taiwan’s National Health Insurance Research Database (NHIRD). Enrolled patients were stratified into hip and spine surgery at the same admission (Both), hip surgery before spine surgery (HS), or spine surgery before hip surgery (SH). The SH group was further subdivided based on whether spine surgery was performed by an orthopedic surgeon (OS) or neurosurgeon (NS), and differences in preoperative radiographic examinations and diagnoses were collected and analyzed. Results: In total, 1824 patients received lumbar spine surgery within 1 year before or after hip replacement surgery. Of these, 103 patients had spine and hip surgery in the same admission (Both), 1290 patients had spine surgery before hip surgery (SH), and 431 patients had hip surgery before spine surgery (HS). In the SH group, patients were categorized into spine surgery by orthopedic surgeons (OS) (n = 679) or neurosurgeons (NS) (n = 522). In the SH group, orthopedic surgeons investigated hip pathology with X-rays more often (52.6% vs. 38.1%, p < 0.001) and diagnosed more cases of hip disease (43.6% vs. 28.9%, p < 0.001) than neurosurgeons. Conclusions: Of patients in Taiwan’s NHIRD who had concurrent surgical degenerative hip and lumbar spine disorders who had spine surgery before hip surgery, orthopedic surgeons obtained hip images and made hip-related diagnoses more frequently than did neurosurgeons.

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Are the Roland Morris Disability Questionnaire and Oswestry Disability Index interchangeable in patients after lumbar spinal fusion?

Journal of Back and Musculoskeletal Rehabilitation ◽

10.3233/bmr-200206 ◽

2021 ◽

pp. 1-7

Author(s):

R.F.M.R. Kersten ◽

J. Fikkers ◽

N. Wolterbeek ◽

F.C. Öner ◽

S.M. van Gaalen

Keyword(s):

Back Pain ◽

Spinal Fusion ◽

Outcome Measures ◽

Oswestry Disability Index ◽

Roland Morris Disability Questionnaire ◽

Leg Pain ◽

Lumbar Spinal Fusion ◽

Patient Reported ◽

Disability Questionnaire ◽

Lumbar Spinal

BACKGROUND: Low back pain is a common health problem for which there are several treatment options. For optimizing clinical decision making, evaluation of treatments and research purposes it is important that health care professionals are able to evaluate the functional status of patients. Patient reported outcome measures (PROMs) are widely accepted and recommended. The Roland Morris Disability Questionnaire (RMDQ) and the Oswestry Disability Index (ODI) are the two mainly used condition-specific patient reported outcomes. Concerns regarding the content and structural validity and also the different scoring systems of these outcome measures makes comparison of treatment results difficult. OBJECTIVE: Aim of this study was to determine if the RMDQ and ODI could be used exchangeable by assessing the correlation and comparing different measurement properties between the questionnaires. METHODS: Clinical data from patients who participated in a multicenter RCT with 2 year follow-up after lumbar spinal fusion were used. Outcome measures were the RMDQ, ODI, Short Form 36 – Health Survey (SF-36), leg pain and back pain measured on a 0–100 mm visual analogue scale (VAS). Cronbach’s alpha coefficients, Spearman correlation coefficients, multiple regression analysis and Bland-Altman plots were calculated. RESULTS: three hundred and seventy-six completed questionnaires filled out by 87 patients were used. The ODI and RMDQ had both a good level of internal consistency. There was a very strong correlation between the RMDQ and the ODI (r= 0.87; p< 0.001), and between the VAS and both the ODI and RMDQ. However, the Bland-Altman plot indicated bad agreement between the ODI and RMDQ. CONCLUSIONS: The RMDQ and ODI cannot be used interchangeably, nor is there a possibility of converting the score from one questionnaire to the other. However, leg pain and back pain seemed to be predictors for both the ODI and the RMDQ.

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