Developing the Total Disability Index Based on an Analysis of the Interrelationships and Limitations of Oswestry and Neck Disability Index

Spiegel, Matthew; Lafage, Renaud; Lafage, Virginie; Ryan, Devon; Marascalchi, Bryan J.; Trimba, Yuriy; Christopher, Ames; Harris, Bradley; Tanzi, Elizabeth L.; Oren, Jonathan H.; Vira, Shaleen; Errico, Thomas J.; Schwab, Frank J.; Protopsaltis, Themistocles S.

doi:10.1097/brs.0000000000001159

Cited by 19 publications

(11 citation statements)

References 21 publications

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“…Previous authors have questioned the reliability of several sections of the ODI questionnaire including "Heavy weight lifting" and "Sex life." 20,22,46 However, given the proven overall reliability, validity, ease of administration, high sensitivity and specificity for low-back pain, the ODI is the most commonly used and well-accepted measure of disability for lumbar spine disease. In the present analysis, the decision to compare the 3-and 12-month outcomes using the ODI was based on the premise that the ODI is the most responsive and valid measure of functional outcomes following lumbar spine surgery.…”

Section: Study Limitationsmentioning

confidence: 99%

Inadequacy of 3-month Oswestry Disability Index outcome for assessing individual longer-term patient experience after lumbar spine surgery

Asher

Chotai

Devin

et al. 2016

SPI

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OBJECTIVE Prospective longitudinal outcomes registries are at the center of evidence-driven health care reform. Obtaining real-world outcomes data at 12 months can be costly and challenging. In the present study, the authors analyzed whether 3-month outcome measurements sufficiently represent 12-month outcomes for patients with degenerative lumbar disease undergoing surgery. METHODS Data from 3073 patients undergoing elective spine surgery for degenerative lumbar disease were entered into a prospective multicenter registry (N2QOD). Baseline, 3-month, and 12-month follow-up Oswestry Disability Index (ODI) scores were recorded. The absolute differences between actual 12- and 3-month ODI scores was evaluated. Additionally, the authors analyzed the absolute difference between actual 12-month ODI scores and a model-predicted 12-month ODI score (the model used patients' baseline characteristics and actual 3-month scores). The minimal clinically important difference (MCID) for ODI of 12.8 points and the substantial clinical benefit (SCB) for ODI of 18.8 points were used based on the previously published values. The concordance rate of achieving MCID and SCB for ODI at 3-and 12-months was computed. RESULTS The 3-month ODI scores differed from 12-month scores by an absolute difference of 11.9 ± 10.8, and predictive modeling estimations of 12-month ODI scores differed from actual 12-month scores by a mean (± SD) of 10.7 ± 9.0 points (p = 0.001). Sixty-four percent of patients (n = 1982) achieved an MCID for ODI at 3 months in comparison with 67% of patients (n = 2088) by 12 months; 51% (n = 1731) and 61% (n = 1860) of patients achieved SCB for ODI at 3 months and 12 months, respectively. Almost 20% of patients had ODI scores that varied at least 20 points (the point span of an ODI functional category) between actual 3- and 12-month values. In the aggregate analysis of achieving MCID, 77% of patients were concordant and 23% were discordant in achieving or not achieving MCID at 3 and 12 months. The discordance rates of achieving or not achieving MCID for ODI were in the range of 19% to 27% for all diagnoses and treatments (decompression with and without fusion). The positive and negative predictive value of 3-months ODI to predict 12-month ODI was 86% and 60% for MCID and 82% and 67% for SCB. CONCLUSIONS Based on their findings, the authors conclude the following: 1) Predictive methods for functional outcome based on early patient experience (i.e., baseline and/or 3-month data) should be used to help evaluate the effectiveness of procedures in patient populations, rather than serving as a proxy for long-term individual patient experience. 2) Prospective longitudinal registries need to span at least 12 months to determine the effectiveness of spine care at the individual patient and practitioner level.

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Section: Study Limitationsmentioning

confidence: 99%

Inadequacy of 3-month Oswestry Disability Index outcome for assessing individual longer-term patient experience after lumbar spine surgery

Asher

Chotai

Devin

et al. 2016

SPI

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“…Operative time, incision length, blood loss, JOA score (1 year after surgery), VAS score (1 year after surgery) and wound pain (3 days and 2 weeks after surgery) were compared between the two approaches. The ODI was used to evaluate quality of life (0–100%) . The higher the ODI score, the worse the quality of life is.…”

Section: Methodsmentioning

confidence: 99%

Mini‐invasive Transforaminal Lumbar Interbody Fusion through Wiltse Approach to Treating Lumbar Spondylolytic Spondylolisthesis

Zhou

Tian

Zheng

et al. 2016

Orthopaedic Surgery

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“…Fifth—as in other studies 35 —we combined the NDI and ODI into one score, although there is literature supporting that there might be differences. 36 Sixth, although radiation for chondrosarcoma is controversial; there is some evidence that high-dose (photon and proton combined) radiation has an effect. 13 A recent study on spine chordoma demonstrates that patients who underwent preoperative radiation do better than postoperative radiation.…”

Section: Discussionmentioning

confidence: 99%

Physical Function and Quality of Life After Resection of Mobile Spine Chondrosarcoma

Pereira

Janssen

Stoop

et al. 2019

Global Spine Journal

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Study Design: Retrospective cohort study. Objectives: (1) To assess patient-reported outcomes—physical function, pain, and quality of life—in patients who underwent resection of a mobile spine chondrosarcoma. (2) To assess complications (90 days), readmissions, reoperations, oncological outcomes, and neurologic status. Methods: Thirty-three patients with spinal conventional chondrosarcoma resection between 1984 and 2014 at one hospital were included. The primary outcome measures were—minimally 6 months after surgery—the EuroQol 5 Dimensions (EQ5D), PROMIS–Physical Function, PROMIS–Pain Intensity, and Oswestry (ODI) Disability Index, or Neck (NDI) Disability established in 14 out of 20 alive (70.0%) patients. Complications, readmission, reoperations, oncological outcomes, and neurological status were reported for the complete cohort of 33 patients. Results: After spine chondrosarcoma resection, patients (n = 14) reported worse physical function (median 43, range 22-61, P = .026), worse quality of life (median EQ5D 0.70, range 0.04-1, P = .022), and comparable pain intensity (median 47, range 31-56, P = .362) when compared with US general population values. The median NDI/ODI was 25 (range 0-72) indicating mild to moderate disability. Patients undergoing reoperation had worse patient-reported outcomes than those who did not. Eighteen (55.5%) out of 33 patients suffered complications (90 days), 14 (42.4%) had unplanned readmission, and 13 (39.4%) underwent reoperation. Intralesional resection was associated with increased readmission, reoperation, and recurrence rate. Conclusions: Chondrosarcoma affects quality of life and physical function and its treatment frequently results in complications and reoperations. Our findings can be used to inform future patients about expected outcomes.

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Developing the Total Disability Index Based on an Analysis of the Interrelationships and Limitations of Oswestry and Neck Disability Index

Cited by 19 publications

References 21 publications

Inadequacy of 3-month Oswestry Disability Index outcome for assessing individual longer-term patient experience after lumbar spine surgery

Inadequacy of 3-month Oswestry Disability Index outcome for assessing individual longer-term patient experience after lumbar spine surgery

Mini‐invasive Transforaminal Lumbar Interbody Fusion through Wiltse Approach to Treating Lumbar Spondylolytic Spondylolisthesis

Physical Function and Quality of Life After Resection of Mobile Spine Chondrosarcoma

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