Chapter 38 Outcome Measurements for Minimally Invasive Percutaneous Spine Techniques

Kyung-Hoon Kim, MD, PhD, Cheul-Hong Kim, MD, PhD

Various outcome scales

There are various outcome scales for measuring the results of minimal invasive percutaneous spine procedures. The most commonly used of these scales are presented in this chapter.

Table 38.1 A Proposed Set of Patient-Based Outcome Measures for Use in Spinal Disorders

Back-specific function measures

BOX 38-1 Selected Back-Specific Functional Instruments

Oswestry Low Back Pain Disability Questionnaire (ODQ)

Roland Morris Disability Questionnaire (RMDQ)

Million Visual Analogue Scale (MVAS)

Waddell Disability Index (WDI)

Low Back Outcome Score (LBOS)

Clinical Back Pain Questionnaire (CBPQ; Aberdeen Low Back Pain Scale)

Low Back Pain Rating Scale (LBPRS)

Quebec Back Pain Disability Scale (QBPDS)

North American Spine Society Lumbar Spine Questionnaire (NASS LSQ)

Resumption of Activities of Daily Living Scale (RADL)

Scoring System for Low Back Pain Proposed by Japanese Orthopaedic Association (JOA)

Table 38.2 Descriptive Information for Selected Back-Specific Functional Instruments

Table 38.3 Comparison between Roland Morris Disability Questionnaire and Oswestry Low Back Pain Disability Questionnaire (ODQ)

BOX 38-2 The Roland Morris Disability Questionnaire (RDQ)* [1]

When your back hurts, you may find it difficult to do some things you normally do. This list contains sentences that people have used to describe themselves when they have back pain. When you read them, you may find that some stand out because they describe you today. As you read the list, think of yourself today. When you read a sentence that describes you today, put a tick against it. If the sentence does not describe you, then leave the space blank and go on to the next one. Remember; only tick the sentence if you are sure it describes you today.

1. I stay at home most of the time because of my back.

2. I change position frequently to try and get my back comfortable.

3. I walk more slowly than usual because of my back.

4. Because of my back I am not doing any of the jobs that I usually do around the house.

5. Because of my back, I use a handrail to get upstairs.

6. Because of my back, I lie down to rest more often.

7. Because of my back, I have to hold on to something to get out of an easy chair.

8. Because of my back, I try to get other people to do things for me.

9. I get dressed more slowly than usual because of my back.

10. I only stand for short periods of time because of my back.

11. Because of my back, I try not to bend or kneel down.

12. I find it difficult to get out of a chair because of my back.

13. My back is painful almost all the time.

14. I find it difficult to turn over in bed because of my back.

15. My appetite is not very good because of my back pain.

16. I have trouble putting on my socks (or stockings) because of the pain in my back.

17. I only walk short distances because of my back.

18. I sleep less well on my back.

19. Because of my back pain, I get dressed with help from someone else.

20. I sit down for most of the day because of my back.

21. I avoid heavy jobs around the house because of my back.

22. Because of my back pain, I am more irritable and bad tempered with people than usual.

23. Because of my back, I go upstairs more slowly than usual.

24. I stay in bed most of the time because of my back.

^* The score is the total number of items checked—i.e., from a minimum of 0 to a maximum of 24.

BOX 38-3 Oswestry Low Back Pain Disability Questionnaire (ODQ) [2]

Could you please complete this questionnaire? It is designed to give us information as to how your back (or leg) trouble has affected your ability to manage in everyday life. Please answer every section. Mark one box only in each section that most closely describes you today.

Section 1: Pain Intensity

I have no pain at the moment.

The pain is very mild at the moment.

The pain is moderate at the moment.

The pain is fairly severe at the moment.

The pain is very severe at the moment.

The pain is the worst imaginable at the moment.

Section 2: Personal Care (washing, dressing, etc.)

I can look after myself normally without causing extra pain.

I can look after myself normally but it is very painful.

It is painful to look after myself and I am slow and careful.

I need some help but manage most of my personal care.

I need help every day in most aspects of self-care.

I do not get dressed, wash with difficulty, and stay in bed.

Section 3: Lifting

I can lift heavy weights without extra pain.

I can lift heavy weights but it gives extra pain.

Pain prevents me from lifting heavy weights off the floor but I can manage if they are conveniently positioned, e.g., on a table.

Pain prevents me from lifting heavy weights but I can manage light to medium weights if they are conveniently positioned.

I can lift only very light weights.

I cannot lift or carry anything at all.

Section 4: Walking

Pain does not prevent me walking any distance.

Pain prevents me walking more than 1 mile.

Pain prevents me walking more than a quarter of a mile.

Pain prevents me walking more than 100 yards.

I can only walk using a stick or crutches.

I am in bed most of the time and have to crawl to the toilet.

Section 5: Sitting

I can sit in any chair as long as I like.

I can sit in my favorite chair as long as I like.

Pain prevents me from sitting for more than 1 hour.

Pain prevents me from sitting for more than half an hour.

Pain prevents me from sitting for more than 10 minutes.

Pain prevents me from sitting at all.

Section 6: Standing

I can stand as long as I want without extra pain.

I can stand as long as I want but it gives extra pain.

Pain prevents me from standing for more than 1 hour.

Pain prevents me from standing for more than half an hour.

Pain prevents me from standing for more than 10 minutes.

Pain prevents me from standing at all.

Section 7: Sleeping

My sleep is never disturbed by pain.

My sleep is occasionally disturbed by pain.

Because of pain I have less than 6 hours’ sleep.

Because of pain I have less than 4 hours’ sleep.

Because of pain I have less than 2 hours’ sleep.

Pain prevents me from sleeping at all.

Section 8: Sex Life (if applicable)

My sex life is normal and causes no extra pain.

My sex life is normal but causes some extra pain.

My sex life is nearly normal but is very painful.

My sex life is severely restricted by pain.

My sex life is nearly absent because of pain.

Section 9: Social Life

My social life is normal and causes me no extra pain.

My social life is normal but increases the degree of pain.

Pain has no significant effect on my social life apart from limiting my more energetic interests, e.g., sport, etc.

Pain has no restricted my social life and I do not go out as often.

Pain has restricted social life to my home.

I have no social life because of pain.

Section 10: Traveling

I can travel anywhere without pain.

I can travel anywhere but it gives extra pain.

Pain is bad but I manage journeys over 2 hours.

Pain restricts me to journeys of less than 1 hour.

Pain restricts me to short necessary journeys under 30 minutes.

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