Why and how should we measure outcomes in spine surgery?

Teles, Alisson Roberto; Khoshhal, Khalid I.; Falavigna, Asdrúbal

doi:10.1016/j.jtumed.2016.01.003

Cited by 9 publications

(14 citation statements)

References 62 publications

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“…As discussed, functional recovery post spinal procedures is currently reported via proxy parameters such as quality of life, pain and functional scores (VAS, ODI, SF12/SF36, Roland Morris disability index), and duration of hospital stay (8). However, subjective measures alone are strongly influenced by inherent bias and individual variation.…”

Section: Discussionmentioning

confidence: 99%

“…Traditionally, quantification and comparison of recovery or outcomes in patient's post-spinal procedures used subjective rating scores such as Oswestry Disability Index (ODI), Visual Analogue pain Scale scores (VAS), Short Form Health (SF-12, SF-36) survey scores amongst a variety of others (6)(7)(8). However, the major problem in utilizing these scores is their subjectivity and the inherent bias with self-appraisal, as different individuals perceive and tolerate pain differently (9).…”

Section: Introductionmentioning

confidence: 99%

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Objective monitoring of activity and Gait Velocity using wearable accelerometer following lumbar microdiscectomy to detect recurrent disc herniation

Mobbs¹,

Katsinas²,

Choy³

et al. 2018

J Spine Surg

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We report a case of a 39-year-old male with sciatica who underwent an L5/S1 microdiscectomy with objective physical activity measurements performed preoperatively and continually postoperatively up to 3-month using wireless accelerometer technology linked to the surgical practice; collecting distance travelled, daily step count (DSC) and Gait Velocity (GV). Preoperative, the patient was walking with a GV of 0.97 m/s and a DSC of less than 2,500. After the first month following surgery, the patient had increased mobility, with a GV of 1.58 m/s, and taking an average of over 4,500 steps per day. At day 57 postop, the patient experienced a recurrence of pain with reduction of GV, DSC and walking distance. Magnetic resonance imaging (MRI) was performed and revealed a recurrent disc herniation with further surgery on day 63, with a rapid return of function post 2 nd surgery. The use of wireless accelerometers is practical in obtaining objective physical activity measurements before and after lumbar microdiscectomy, and will assist the surgeon and rehabilitation provider to monitor outcomes, complications and assist in clinical decision making.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Objective monitoring of activity and Gait Velocity using wearable accelerometer following lumbar microdiscectomy to detect recurrent disc herniation

Mobbs¹,

Katsinas²,

Choy³

et al. 2018

J Spine Surg

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“…Degenerative spinal disorders have adverse impacts on patients’ quality of life. Because the main objectives of any surgical intervention are to improve health-related quality of life and to reduce disability, instruments capable of measuring patient-oriented outcomes are now increasingly used to evaluate the clinical and functional outcomes from the patients’ perspectives [6].…”

Section: Introductionmentioning

confidence: 99%

SF36 Is a Reliable Patient-Oriented Outcome Evaluation Tool in Surgically Treated Degenerative Cervical Myelopathy Cases: A Systematic Review and Meta-Analysis

Wang¹,

Dong

2019

Med Sci Monit

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BackgroundDegenerative spinal disorders have adverse impacts on patients’ quality of life. Because the main objectives of any surgical intervention are to improve health-related quality of life and to reduce disability, instruments capable of measuring patient-oriented outcomes are now increasingly used. The aim of this study was to evaluate the use of the Short Form 36 Health Survey Questionnaire (SF36) for assessing patient-oriented outcomes of degenerative cervical myelopathy surgery.Material/MethodsA literature search was conducted in electronic databases (Google Scholar, Ovid SP, PubMed, Science Direct, and Springer). Studies were included if they reported SF36 scores by following patients for at least 12 months. Random effects meta-analyses were performed to estimate changes in SF36 physical/mental component summary (SF36-PCS/MCS), SF36 dimensional, Japanese Orthopedics Association (JOA)/modified JOA (mJOA), and Neck Disability Index (NDI) scores by latest follow-up.ResultsFourteen studies (1966 patients; age 58.2 years [95% confidence interval (CI), 56.6 to 59.9]; 60% males [95% CI, 55 to 64]; follow-up 24.8 months [95% CI, 20.9 to 28.7]) were included in meta-analysis. SF36-PCS (6.60 [95% CI, 4.91 to 8.28]; p<0.00001), SF36-MCS (6.33 [95% CI, 4.31 to 8.35]; p<0.00001) and SF36 dimensional (p<0.05) scores improved significantly at latest follow-up. Surgery significantly improved JOA/mJOA (3.43 [95% CI, 2.80 to 4.06]; p<0.00001) and NDI (−13.70 [95% CI, −17.35 to −10.06]; p<0.00001) scores also. Change in SF36-PCS score were correlated (r=−0.554) with change in NDI score, whereas change in SF36-MCS score was correlated with change in JOA score (r=0.550).ConclusionsSurgery for degenerative cervical myelopathy is associated with significantly improved SF36-measured patient-oriented outcomes.

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“…Many related studies found that ODI Questionnaire has good reliability, validity and responsiveness that is commonly used for clinical practice [10,11] . On the other hand, there are limited studies that convey NCOS as a tool for measuring functional status in patients with lumbar spinal stenosis.…”

Section: Discussionmentioning

confidence: 99%

Untitled

2018

Int. J. Orthop. Sci.

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Degenerative lumbar spinal canal stenosis (LSCS) is a narrowing of the spinal canal or intervertebral foramina secondary to degenerative changes. Current treatments focused mainly on improving the functional outcome and quality of life. Functional outcome is assessed by measuring level of satisfaction, pain, disability, range of motion and radiographic measurements. The Neurogenic Claudication Outcome Score (NCOS) and Oswestry Disability Index (ODI) are tools commonly employed to assess the functional outcome of such patients and have been shown to strongly correlate with level of disability in a group of patients with lumbar spinal stenosis. The aim of this study is to compare the responsiveness of NCOS and ODI in measuring the functional outcome of patients with degenerative LSCS post decompression, stabilization and fusion. This is a prospective study involving 36 patients diagnosed with degenerative LSCS for a period of 5 years. Patients were assessed during pre-operation and at 3-month post-operation. We found that There are significant differences between the preoperative NCOS and ODI compared to 3 months post-operative, with effect size of 0.61 for NCOS and 0.54 for ODI. Both NCOS and ODI questionnaires exhibit good responsiveness in assessing the functional outcome of patients with degenerative LSCS, however NCOS was shown to be more responsive than ODI.

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Why and how should we measure outcomes in spine surgery?

Cited by 9 publications

References 62 publications

Objective monitoring of activity and Gait Velocity using wearable accelerometer following lumbar microdiscectomy to detect recurrent disc herniation

Objective monitoring of activity and Gait Velocity using wearable accelerometer following lumbar microdiscectomy to detect recurrent disc herniation

SF36 Is a Reliable Patient-Oriented Outcome Evaluation Tool in Surgically Treated Degenerative Cervical Myelopathy Cases: A Systematic Review and Meta-Analysis

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