Abstract
Background: The usefulness of the Nottingham Health Profile as a generic quality of health outcome measure has been described in a number of Orthopaedic conditions. This study was done to compare two quality of life questionnaires, the Nottingham Health Profile (NHP) and the Oswestry Disability Index (ODI) regarding the internal consistency, validity and responsiveness as outcome measures in patients undergoing surgery for lumbar nerve root decompression. We also assessed the effects of smoking, type of lesion, clinical presentation, number of levels involved, operating surgeon and duration of symptoms.
Methods: 37 patients with clinical nerve root entrapment, confirmed radiologically were treated with decompression surgery by two surgeons. We used the NHP and the ODI to assess the severity of symptoms prior to and at 3 and 8 months following surgery
Results: We were unable to detect factors predictive of better healthcare outcome scores after surgery for sciatica. There was a statistically significant improvement in the total ODI score and all NHP domain scores within the whole cohort, after treatment. NHP had a greater responsiveness in detecting improvement for pain and physical ability as measured by the effect size. Cronbach’s alpha for reliability of scores was consistently above the acceptable threshold of 0.90 for NHP scores and consistently below 0.90 for ODI scores. A “floor and ceiling” analysis revealed that the NHP consistently skewed scores at 3 months post op towards a better outcome compared to the ODI.
Conclusion: The generic Nottingham Health Profile appears to be a more sensitive health questionnaire than the Oswestry Disability Index in assessing the outcome of nerve root decompression surgery. We were unable to identify factors predictive of better outcomes using these scores as outcome measures.
The abstracts were prepared by Major SA Adams. Correspondence should be addressed to Major M Butler, CSOS, Institute of Naval Medicine, Crescent Road, Alverstoke, Hants PO12 2DL
