Abstract
Aims
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to determine what aspects of people’s lives (domains of impact) where most affected by their spinal problems,
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to determine the extent to which the SF-36 and ODI represent these domains,
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to compare the domains of impact resulting from neck and low back pain.
Methods & Results: Data was collected prospectively. New patients attending the spinal clinic completed a questionnaire about their symptoms. They were also asked to list, in order of importance to them, the 3 aspects of their daily life most affected by their symptoms. Responses were in free text format, summarised with the most appropriate single word response (e.g. walking) and grouped. Thoraco-lumbar and cervical pain/pathology were analyzed separately. We computed: (1) the total number of domains of impact identified; (2) the frequency (%) each domain was listed 1st; (3)the frequency (%) each domain was listed 1st, 2nd, or 3rd
Cervical pathology (n=200 people).
19 domains were identified. Of domains identified as first most important (n=164) 3 domains predominated: work (28%), sleep (24%), walking (24%). Others ranged from 0 – 7.6%. Of all domains identified by all people (n=399), 4 predominated: sleep (62%), work (54%), walking (41%) sitting (36%). Others ranged from 0.6% to 9.8%.
Thoraco-Lumbar pathology (n=537 people).
25 domains were identified. Of domains identified as first most important (n=429) 4 domains predominated: walking (49%), working (18%), sitting (12%) and sleeping (11%). Others ranged from 0 – 7.6%. Of all domains identified by all people (n=1096), 4 predominated: sleep (76%), work (50%), walking (47%) sitting (45%). Others ranged from 0.2% to 11.9%.
Conclusions: People with spinal problems consistently identify 4 main domains of impact: working, walking, sleeping and sitting. This is not reflected by SF-36 and ODI. Further work is required to ensure that scale selection for assessing the impact of spinal pathology and its management is evidence based.
Ethics approval: none
Interest statement: none
Correspondence should be addressed to BASS/BCSS c/o BOA, at the Royal College of Surgeons, 35–43 Lincoln’s Inn Fields, London, WC2A 3PE, England.
