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

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.

scholarly journals Minimally invasive versus open lumbar spinal fusion: a matched study investigating patient-reported and surgical outcomes

2021 ◽  
pp. 1-14
Author(s):  
James Mooney ◽  
Giorgos D. Michalopoulos ◽  
Mohammed Ali Alvi ◽  
Daniel Zeitouni ◽  
Andrew K. Chan ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Spinal Fusion ◽  
Operative Time ◽  
Lumbar Fusion ◽  
Leg Pain ◽  
Lumbar Spinal Fusion ◽  
Patient Reported ◽  
Lumbar Spinal ◽  
Incidental Durotomy

OBJECTIVE With the expanding indications for and increasing popularity of minimally invasive surgery (MIS) for lumbar spinal fusion, large-scale outcomes analysis to compare MIS approaches with open procedures is warranted. METHODS The authors queried the Quality Outcomes Database for patients who underwent elective lumbar fusion for degenerative spine disease. They performed optimal matching, at a 1:2 ratio between patients who underwent MIS and those who underwent open lumbar fusion, to create two highly homogeneous groups in terms of 33 baseline variables (including demographic characteristics, comorbidities, symptoms, patient-reported scores, indications, and operative details). The outcomes of interest were overall satisfaction, decrease in Oswestry Disability Index (ODI), and back and leg pain, as well as hospital length of stay (LOS), operative time, reoperations, and incidental durotomy rate. Satisfaction was defined as a score of 1 or 2 on the North American Spine Society scale. Minimal clinically important difference (MCID) in ODI was defined as ≥ 30% decrease from baseline. Outcomes were assessed at the 3- and 12-month follow-up evaluations. RESULTS After the groups were matched, the MIS and open groups consisted of 1483 and 2966 patients, respectively. Patients who underwent MIS fusion had higher odds of satisfaction at 3 months (OR 1.4, p = 0.004); no difference was demonstrated at 12 months (OR 1.04, p = 0.67). Lumbar stenosis, single-level fusion, higher American Society of Anesthesiologists Physical Status Classification System grade, and absence of spondylolisthesis were most prominently associated with higher odds of satisfaction with MIS compared with open surgery. Patients in the MIS group had slightly lower ODI scores at 3 months (mean difference 1.61, p = 0.006; MCID OR 1.14, p = 0.0495) and 12 months (mean difference 2.35, p < 0.001; MCID OR 1.29, p < 0.001). MIS was also associated with a greater decrease in leg and back pain at both follow-up time points. The two groups did not differ in operative time and incidental durotomy rate; however, LOS was shorter for the MIS group. Revision surgery at 12 months was less likely for patients who underwent MIS (4.1% vs 5.6%, p = 0.032). CONCLUSIONS In patients who underwent lumbar fusion for degenerative spinal disease, MIS was associated with higher odds of satisfaction at 3 months postoperatively. No difference was demonstrated at the 12-month follow-up. MIS maintained a small, yet consistent, superiority in decreasing ODI and back and leg pain, and MIS was associated with a lower reoperation rate.

scholarly journals Guideline update for the performance of fusion procedures for degenerative disease of the lumbar spine. Part 2: Assessment of functional outcome following lumbar fusion

2014 ◽  
Vol 21 (1) ◽  
pp. 7-13 ◽  
Author(s):  
Zoher Ghogawala ◽  
Daniel K. Resnick ◽  
William C. Watters ◽  
Praveen V. Mummaneni ◽  
Andrew T. Dailey ◽  
...  
Keyword(s):  
Lumbar Spine ◽  
Functional Outcome ◽  
Spinal Fusion ◽  
Lumbar Fusion ◽  
Minimum Clinically Important Difference ◽  
Degenerative Disease ◽  
Psychological State ◽  
Lumbar Spinal Fusion ◽  
Patient Reported ◽  
Lumbar Spinal

Assessment of functional patient-reported outcome following lumbar spinal fusion continues to be essential for comparing the effectiveness of different treatments for patients presenting with degenerative disease of the lumbar spine. When assessing functional outcome in patients being treated with lumbar spinal fusion, a reliable, valid, and responsive outcomes instrument such as the Oswestry Disability Index should be used. The SF-36 and the SF-12 have emerged as dominant measures of general health-related quality of life. Research has established the minimum clinically important difference for major functional outcomes measures, and this should be considered when assessing clinical outcome. The results of recent studies suggest that a patient's pretreatment psychological state is a major independent variable that affects the ability to detect change in functional outcome.

32. Does the number of patient-reported allergies impact clinical outcomes after lumbar spinal fusion?

2019 ◽  
Vol 19 (9) ◽  
pp. S16
Author(s):  
Jannat M. Khan ◽  
Bryce Basques ◽  
Dong Gue Oh ◽  
Zayd Hayani ◽  
Jennifer Hwang ◽  
...  
Keyword(s):  
Spinal Fusion ◽  
Clinical Outcomes ◽  
Lumbar Spinal Fusion ◽  
Patient Reported ◽  
Lumbar Spinal

scholarly journals Postoperative satisfaction following lumbar spinal fusion surgery: patient expectation versus actuality

2019 ◽  
Vol 31 (5) ◽  
pp. 676-682 ◽  
Author(s):  
Joon S. Yoo ◽  
Dil V. Patel ◽  
Benjamin C. Mayo ◽  
Dustin H. Massel ◽  
Sailee S. Karmarkar ◽  
...  
Keyword(s):  
Patient Satisfaction ◽  
Back Pain ◽  
Minimally Invasive ◽  
Outcome Measures ◽  
Lumbar Fusion ◽  
Leg Pain ◽  
Strong Correlations ◽  
Patient Reported ◽  
Preoperative Expectation ◽  
Postoperative Symptoms

OBJECTIVEDue to the reported benefits associated with minimally invasive spine surgery (MIS), patients seeking out minimally invasive surgery may have higher expectations regarding their outcomes. In this study the authors aimed to assess the effects of preoperative expectations and postoperative outcome actuality, and the difference between the two, on postoperative satisfaction following MIS for lumbar fusion procedures.METHODSPatients scheduled for either a 1- or 2-level lumbar fusion MIS were administered confidential surveys preoperatively and at 6 months postoperatively. The surveys administered preoperatively consisted of 2 parts: preoperative patient-reported outcomes (PROs), including the Oswestry Disability Index (ODI), visual analog scale (VAS) back pain, and VAS leg pain, and expected postoperative PROs. The surveys administered 6 months postoperatively consisted of 2 parts: postoperative PROs and satisfaction. Preoperative symptoms, expected postoperative symptoms, and actual postoperative symptoms were compared using paired t-tests. Pearson correlation was used to compare the association between 1) postoperative change in PROs and satisfaction, 2) expectation and satisfaction, 3) expectation-actuality discrepancy and satisfaction, and 4) actuality and satisfaction.RESULTSIn total, 101 patients completed all surveys. Patients expected to improve in all PROs from baseline, except for ODI personal care, in which they expected to get worse after surgery. In actuality, patients improved in all PROs from baseline, except for ODI personal care, in which they did not demonstrate improvement or worsening. Patients did not surpass any expectations regarding PRO improvement. The association between patient satisfaction and postoperative change was strong for the VAS back pain score, while ODI and VAS leg pain scores showed moderate correlations. Preoperative expectation and postoperative satisfaction demonstrated weak to moderate correlations for all outcome measures. All 3 PROs demonstrated moderate correlation between patient satisfaction and the expectation-actuality discrepancy. All 3 PROs demonstrated strong correlations between satisfaction and actual postoperative outcomes, with ODI having the strongest correlation.CONCLUSIONSIn this observational study, the authors determined that the actual postoperative results following surgery were strongly correlated with patient satisfaction, while the patients’ expectation, the expectation-actuality discrepancy, and the postoperative improvement did not demonstrate strong correlations for all patient-reported outcome measures utilized in this study. The investigation results suggest that the most important indicator of how satisfied patients feel following surgery may be the actual outcome itself, rather than the preoperative expectation or the degree to which the expected result was met.

scholarly journals Εμβιομηχανική ανάλυση βάδισης σε ασθενείς με χρόνια οσφυαλγία πριν και μετά την εφαρμογή ειδικών φυσιοθεραπευτικών τεχνικών

2015 ◽  
Author(s):  
Γεώργιος Κρεκούκιας
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Visual Analog Scale ◽  
Oswestry Disability Index ◽  
Degenerative Disease ◽  
Leg Pain ◽  
Low Back ◽  
Greek Version ◽  
Analog Scale ◽  
Disability Questionnaire

Εισαγωγή: οι ασθενείς που πάσχουν από χρόνια οσφυαλγία ως συνέπεια της νόσου του εκφυλισμένου δίσκου, εκτός από πόνο εμφανίζουν επίσης και διαταραχή της βάδισής τους. Ο σκοπός της μελέτης είναι η αξιολόγηση τόσο των κλινικών δεδομένων με την χρήση κλινικών κλιμάκων αξιολόγησης, όπως Oswestry Disability Index Greek version (ODI), Visual Analog Scale for low back pain and leg pain (VAS) και το Roland Morris Disability Questionnaire Greek Version, όσο και των κινητικών και κινηματικών χαρακτηριστικών κατά την ανάλυση βάδισης σε ασθενείς με χρόνια οσφυαλγία συνεπεία της νόσου του εκφυλισμένου δίσκου (Disc Degenerative Disease), πριν και μετά την εφαρμογή των ειδικών φυσιοθεραπευτικών τεχνικών (τεχνικών θεραπείας δια χειρός).Μεθοδολογία: για τις ανάγκες της μελέτης 75 ασθενείς που έπασχαν από χρόνια οσφυαλγία, χωρίστηκαν τυχαία σε 3 ομάδες των 25 η καθεμιά. Η κάθε ομάδα δέχθηκε 5 συνεδρίες που για την πρώτη ομάδα ήταν φυσικοθεραπευτικές τεχνικές δια χειρός, για τη δεύτερη ήταν εικονική θεραπεία και για την τρίτη ήταν κλασική φυσικοθεραπεία (διατατικές ασκήσεις, T.E.N.S. και μάλαξη). Προκειμένου να αξιολογηθεί η αποτελεσματικότητα της κάθε θεραπείας χρησιμοποιήθηκε η οπτική αναλογική κλίμακα του πόνου, 2 ερωτηματολόγια (Oswestry και Roland Morris) και επίσης ένα οπτικοηλεκτρονικό σύστημα καταγραφής και ανάλυσης της βάδισης (κινητικά και κινηματικά δεδομένα)Αποτελέσματα: η ομάδα που δέχθηκε τεχνικές δια χειρός εμφάνισε στατιστικά σημαντική μείωση του πόνου και των επιπέδων δυσλειτουργίας. Σε παρόμοια αποτελέσματα οδήγησε και η εφαρμογή κλασικής φυσικοθεραπείας, αλλά η ελάττωση ήταν σαφώς μικρότερη σε σχέση με την ομάδα των τεχνικών δια χειρός. Η ομάδα που δέχθηκε εικονική θεραπεία, δεν είχε κάποια στατιστικά σημαντική διαφορά στα επίπεδα πόνου και δυσλειτουργίας. Σχετικά με την αξιολόγηση της βάδισης, οι ασθενείς στο σύνολό τους, παρουσίασαν διαταραγμένη βάδιση με διαφορά στα κινητικά και κινηματικά δεδομένα μεταξύ δεξιάς και αριστερής πλευράς. Μετά την εφαρμογή των θεραπειών, μόνο η ομάδα που δέχθηκε τεχνικές δια χειρός έδειξε τάση προς συμμετρία μεταξύ δεξιάς και αριστερής πλευράς.Συμπεράσματα: σε περιπτώσεις ασθενών που πάσχουν από χρόνια οσφυαλγία συνεπεία της νόσου του εκφυλισμένου δίσκου, η εφαρμογή 5 συνεδριών τεχνικών δια χειρός δείχνει να βελτιώνει τόσο τα επίπεδα πόνου όσο και δυσλειτουργίας, καθώς επίσης και παρουσιάζει τάση προς συμμετρία στη βάδιση.

scholarly journals Do Clinical Outcomes and Sagittal Parameters Differ Between Diabetics and Nondiabetics for Degenerative Spondylolisthesis Undergoing Lumbar Fusion?

2019 ◽  
Vol 10 (3) ◽  
pp. 286-293
Author(s):  
Jannat M. Khan ◽  
Joseph Michalski ◽  
Bryce A. Basques ◽  
Philip K. Louie ◽  
Oscar Chen ◽  
...  
Keyword(s):  
Postoperative Complications ◽  
Spinal Fusion ◽  
Clinical Outcomes ◽  
Lumbar Fusion ◽  
Degenerative Spondylolisthesis ◽  
Diabetic Patients ◽  
Lumbar Spinal Fusion ◽  
Radiographic Outcomes ◽  
Patient Reported ◽  
Lumbar Spinal

Study Design: Retrospective cohort study. Objective: To assess the effect of diabetes mellitus (DM) on clinical and radiographic outcomes in patient with degenerative spondylolisthesis undergoing posterior lumbar spinal fusion. Methods: Analysis of patients who underwent open posterior lumbar spinal fusion from 2011 to 2018. Patients being medically treated for DM were identified and separated from nondiabetic patients. Visual analogue scale Back/Leg pain and Oswestry Disability Index (ODI) were collected, and achievement of minimal clinically important difference was evaluated. Lumbar lordosis (LL), pelvic tilt (PT), pelvic incidence (PI), and PI-LL difference were measured on radiographs. Rates of postoperative complications were also collected. Results: A total of 850 patients were included; 78 (9.20%) diabetic patients and 772 (90.80%) nondiabetic patients. Final PI-LL difference was significantly larger ( P = .032) for patients with diabetes compared to no diabetes, but there were no other significant differences between radiographic measurements, operative time, or postoperative length of stay. There were no differences in clinical outcomes between the 2 groups. Diabetic patients were found to have a higher rate of discharge to a facility following surgery ( P = .018). No differences were observed in reoperation or postoperative complication. Conclusions: While diabetic patients had more associated comorbidities compared with nondiabetic patients, they had similar patient-reported and radiographic outcomes. Similarly, there are no differences in rates of reoperation or postoperative complications. This study indicates that diabetic patients who have undergone thorough preoperative screening of related comorbidities and appropriate selection should be considered for lumbar spinal fusion.

Does adding case management to standard rehabilitation affect functional ability, pain, or the rate of return to work after lumbar spinal fusion? A randomized controlled trial with two-year follow-up

2020 ◽  
Vol 34 (3) ◽  
pp. 357-368 ◽  
Author(s):  
Lisa Gregersen Oestergaard ◽  
Finn Bjarke Christensen ◽  
Cody Eric Bünger ◽  
Rikke Søgaard ◽  
Randi Holm ◽  
...  
Keyword(s):  
Return To Work ◽  
Spinal Fusion ◽  
Controlled Trial ◽  
Case Manager ◽  
Physical Rehabilitation ◽  
Rehabilitation Programme ◽  
Leg Pain ◽  
Control Group ◽  
Lumbar Spinal Fusion ◽  
Lumbar Spinal

Objective: To examine the effect of a case manager–assisted rehabilitation programme as an add-on to usual physical rehabilitation in patients undergoing lumbar spinal fusion. Design: A randomized controlled trial with a two-year follow-up. Settings: Outpatient clinics of a university hospital and a general hospital. Subjects: In total, 82 patients undergoing lumbar spinal fusion. Interventions: The patients were randomized one-to-one to case manager–assisted rehabilitation (case manager group) or no case manager–assisted rehabilitation (control group). Both groups received usual physical rehabilitation. The case manager–assisted rehabilitation programme included a preoperative meeting with a case manager to determine a rehabilitation plan, postsurgical meetings, phone meetings, and voluntary workplace visits or roundtable meetings. Main measures: Primary outcome was the Oswestry Disability Index. Secondary outcomes were back pain, leg pain, and return to work. Results: Of the 41 patients in the case manager group, 49% were men, with the mean age of 46.1 (±8.7 years). In the control group, 51% were male, with the mean age of 47.4 (±8.9 years). No statistically significant between-group differences were found regarding any outcomes. An overall group effect of 4.1 points (95% confidence interval (CI): –1.8; 9.9) was found on the Oswestry Disability Index, favouring the control group. After two years, the relative risk of return to work was 1.18 (95% CI: 0.8; 1.7), favouring the case manager group. Conclusion: The case manager–assisted rehabilitation programme had no effect on the patients’ functional disability or back and leg pain compared to usual physical rehabilitation. The study lacked power to evaluate the impact on return to work.

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