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Spine

DEGENERATIVE LUMBAR SPINE SURGERY AT A DISTRICT GENERAL HOSPITAL AND THE IMPORTANCE OF PATIENT-REPORTED OUTCOME MEASURE QUESTIONNAIRES

The Society for Back Pain Research (SBPR) Annual General Meeting 2014



Abstract

Aim

To use Patient Reported Outcome Measures (PROMs) to determine the effectiveness of lumbar spinal surgery at a single UK institution.

Methods

Consecutive patients who underwent lumbar spinal surgery (discectomies or decompressions) from 1 January 2011 to 13 March 2013 at a UK District General Hospital were assessed. The procedures were performed or supervised by a senior Consultant Orthopaedic spinal surgeon. All patients completed PROM questionnaires before and three months following surgery. These included Visual Analogue Scores (VAS), SF-12, Oswestry Disability Index (ODI) and Roland Morris Low Back Pain Questionnaire (RMQ).

Results

A total of 230 patients had surgery. Of these, 189 (82%) completed both pre- and post-operative questionnaires. All PROMs showed improvement: VAS for constant back pain improved from 4.1 to 2.1 and exacerbations of back pain from 5.8 to 2.4. VAS for constant leg pain improved from 6.3 to 1.7 and for exacerbations of leg pain from 8.2 to 1.8. Mean ODI from 47 to 21; RMQ from13 to 5; and SF12-psychological and physical components increased by 7.2 and 12.4, respectively. Those patients with better psychological health pre-operatively, (high SF-12 score, >60 [n=14]) had a reduction in mean score (decrease of 3.2) post-operatively. However, those with poorer psychological health pre-operatively (low SF-12 score, <30 [n=18]) showed a marked improvement in mean score post-operatively (increase of 18.9).

Conclusions

These results show that lumbar spinal surgery is safe and effective at a District General Hospital. Baseline psychological scores may help predict psychological outcomes following surgery. This warrants further prospective evaluation.

This abstract has not been previously published in whole or substantial part nor has it been presented previously at a national meeting.

Conflicts of interest: No conflicts of interest

Sources of funding: No funding obtained