Abstract
Introduction: Now that evidence base medicine gains importance scientifically good evaluation of the results of treatment is fundamental. There exist however a large number of evaluation tools for dorsolumbar disorders. These tools measure different aspects of outcome, like pain, impairment, handicap, disability, satisfaction and health perception. These tools are not always well validated either. These problems make it difficult to select the appropriate test for different purposes.
Aim of the study: To compose and evaluate a system of outcome measuring tools that covers most aspects of outcome and that is relevant to spine surgeons.
Materials and Methods: The tests were selected from literature, based on their scientific validity, their relevance, the frequency of their use by others and the ease of their use. The visual analogue scale for pain (VAS-pain), the low back outcome score (LBOS), the handicap subsection of the LBOS, the finger-tip to floor test (FTFT), The Oswestry disability index (ODI) and patient satisfaction were tested in a group of “pure-dorsolumbar-disorder-patients” (selected from a trauma group) and in a group of patients with degenerative disorders, as encountered in a spine surgery practice. The prospectively gathered pre- vs. postop. differences obtained with the different tests were compared with those obtained with the Oswestry disability index, which was chosen as “golden standard”. The obtained correlations (Kendall’s rank correlation coefficients and point-biserial coefficient) are a measure for the construct-validity and responsiveness of the different tests.
Results: The correlation with the ODI was: weak and not significant for VAS-pain in the degenerative group, for FTFT-distance in both groups, for FTFT-pain in the trauma group and for satisfaction in both groups. The same correlation was weak but significant for the VAS-pain in the trauma group and for the LBOS-handicap part in the trauma group. It was moderate for LBOS and the LBOS-disability part in both groups, for the LBOS-handicap part in the degenerative group and for FTFT-pain in the degenerative group. There was no correlation of satisfaction with the other tests. Correlation of FTF- pain with VAS-pain was not significant in the degenerative group and moderate and in the trauma group.
Theses abstracts were prepared by Professor Roger Lemaire. Correspondence should be addressed to EFORT Central Office, Freihofstrasse 22, CH-8700 Küsnacht, Switzerland.
