Accuracy and reproducibility of a retrospective outcome assessment for lumbar spinal stenosis surgery

BMC Musculoskeletal Disorders

Olavi Airaksinen⁶  Veli Turunen³  Heikki Kröger⁵  Petri Sipola²  Sakari Savolainen¹  Ville Leinonen¹  Tapani Heikkilä⁶  Timo Juhani Aalto⁴  Pekka Kuittinen¹ 

[1] Department of Neurosurgery, Kuopio University Hospital, Kuopio, Finland;Department of Clinical Radiology, University of Eastern Finland and Kuopio University Hospital, Kuopio, Finland;Department of Orthopaedics and Traumatology, Kuopio University Hospital, Kuopio, Finland;Kyyhkylä Rehabilitation Center and Hospital, Mikkeli, Finland;Department of Orthopaedics and Traumatology, Kuopio University Hospital and Bone and Cartilage Research Unit, University of Eastern Finland, Kuopio, Finland;Department of Physical and Rehabilitation Medicine, Kuopio University Hospital, Kuopio, Finland

关键词: Outcome measures;    Surgical treatment;    Lumbar spinal stenosis;   

Others  :  1149720
DOI  :  10.1186/1471-2474-13-83

 received in 2011-11-03, accepted in 2012-05-29,  发布年份 2012

【 摘 要 】

Background

Retrospective assessment of surgery outcome is considered problematic. The aims of this study were to evaluate the reproducibility and accuracy of a retrospective outcome assessment of lumbar spinal stenosis surgery with reference to prospective outcome scale measurements.

Method

Outcome of surgery from 100 lumbar spinal stenosis (LSS) patients was evaluated retrospectively from patient files of a 3-month outpatient visit performed according to a standard clinical protocol by two independent researchers. In the retrospective analysis, outcome was graded as 2 = good if the clinical condition had clearly improved, 1 = moderate if it had just slightly improved, 0 = poor if it had not improved or was even worse than before the surgical treatment (Retrospective 3- point scale). A prospectively assessed Oswestry Disability Index questionnaire (ODI), Visual analogue pain scale (VAS) and a patient satisfaction questionnaire were used as references of standards. Reproducibility of the measurements was evaluated.

Results

The retrospective 3-point scale correlated with ODI (r = 0.528; P < 0.001) and VAS (r = 0.368; P < 0.001). The agreement was better in the good and poor outcome than in the moderate outcome. Retrospective 3-point scale demonstrated substantial intra-rater and inter-rater repeatability (κ = 0.682, P < 0.001 and κ = 0.630, P < 0.001, respectively).

Conclusions

Retrospective assessment of spinal surgery outcome is highly reproducible. Accuracy is highest in the patients with poor and good surgical result.

【 授权许可】

   
2012 Kuittinen et al.; licensee BioMed Central Ltd.

【 图 表 】

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【 参考文献 】

• [1]Deyo RA, Mirza SK, Martin BI, Kreuter W, Goodman DC, Jarvik JG: Trends, major medical complications, and charges associated with surgery for lumbar spinal stenosis in older adults. JAMA 2010, 303(13):1259-1265.
• [2]Atlas SJ, Keller RB, Wu YA, Deyo RA, Singer DE: Long-term outcomes of surgical and nonsurgical management of lumbar spinal stenosis: 8 to 10 year results from the maine lumbar spine study. Spine (Phila Pa 1976) 2005, 30(8):936-943.
• [3]Birkmeyer NJ, Weinstein JN: Medical versus surgical treatment for low back pain: evidence and clinical practice. Eff Clin Pract 1999, 2(5):218-227.
• [4]Haefeli M, Elfering A, Aebi M, Freeman BJ, Fritzell P: Guimaraes Consciencia J, Lamartina C, Mayer M, Lund T, Boos N: What comprises a good outcome in spinal surgery? A preliminary survey among spine surgeons of the SSE and European spine patients. Eur Spine J 2008, 17(1):104-116.
• [5]Sinikallio S, Aalto T, Airaksinen O, Herno A, Kroger H, Savolainen S, Turunen V, Viinamaki H: Depression and associated factors in patients with lumbar spinal stenosis. Disabil Rehabil 2006, 28(7):415-422.
• [6]Sinikallio S, Aalto T, Airaksinen O, Herno A, Kroger H, Savolainen S, Turunen V, Viinamaki H: Depression is associated with poorer outcome of lumbar spinal stenosis surgery. Eur Spine J 2007, 16(7):905-912.
• [7]Ostelo RW, Deyo RA, Stratford P, Waddell G, Croft P, Von Korff M, Bouter LM, de Vet HC: Interpreting change scores for pain and functional status in low back pain: towards international consensus regarding minimal important change. Spine (Phila Pa 1976) 2008, 33(1):90-94.
• [8]Fairbank JC, Couper J, Davies JB, O'Brien JP: The Oswestry low back pain disability questionnaire. Physiotherapy 1980, 66(8):271-273.
• [9]Pekkanen L, Kautiainen H, Ylinen J, Salo P, Hakkinen A: Reliability and Validity Study of the Finnish Version 2.0 of the Oswestry Disability Index. Spine (Phila Pa 1976) 2011, 36(4):332-338.
• [10]Beck AT, Ward CH, Mendelson M, Mock J: ERBAUGH J: An inventory for measuring depression. Arch Gen Psychiatry 1961, 4:561-571.
• [11]Raitasalo R: Depression and its association with the need for psychotherapy (article in Finnish). The Social Insurance Institute of Finland publications, Helsinki; 1977:A 13.
• [12]Roland M, Morris R: A study of the natural history of back pain. Part I: development of a reliable and sensitive measure of disability in low-back pain. Spine (Phila Pa 1976) 1983, 8(2):141-144.
• [13]Scott J: HE: Graphic representation of pain.. 1976, 2(2):175-184.
• [14]Airaksinen O, Herno A, Saari T: Surgical treatment of lumbar spinal stenosis: patients' postoperative disability and working capacity. Eur Spine J 1994, 3(5):261-264.
• [15]Herno A, Airaksinen O, Saari T, Svomalainen O: Pre- and postoperative factors associated with return to work following surgery for lumbar spinal stenosis. Am J Ind Med 1996, 30(4):473-478.
• [16]Ware JE, Sherbourne CD: The MOS 36-item short-form health survey (SF-36) I. Conceptual framework and item selection. Med Care 1992, 30(6):473-483.
• [17]The EuroQol Group: Anonymous EuroQol--a new facility for the measurement of health-related quality of life. Health Policy 1990, 16(3):199-208.
• [18]Sintonen H: The 15D instrument of health-related quality of life: properties and applications. Ann Med 2001, 33(5):328-336.
• [19]Waddell G, Newton M, Henderson I, Somerville D, Main CJ: A Fear-Avoidance Beliefs Questionnaire (FABQ) and the role of fear-avoidance beliefs in chronic low back pain and disability. Pain 1993, 52(2):157-168.