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Research ArticleLumbar Spine

Rational Selection of Patient-Reported Outcomes Measures in Lumbar Spine Surgery Patients

Susanne H. Boden, Kevin X. Farley, Collier Campbell, Scott D. Boden and Michael B. Gottschalk
International Journal of Spine Surgery June 2020, 7046; DOI: https://doi.org/10.14444/7046
Susanne H. Boden
1Oakland University William Beaumont School of Medicine, Rochester, Minnesota
BA
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Kevin X. Farley
2Emory University School of Medicine, Department of Orthopaedics, Atlanta, Georgia
BS
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Collier Campbell
2Emory University School of Medicine, Department of Orthopaedics, Atlanta, Georgia
BS
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Scott D. Boden
2Emory University School of Medicine, Department of Orthopaedics, Atlanta, Georgia
MD
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Michael B. Gottschalk
2Emory University School of Medicine, Department of Orthopaedics, Atlanta, Georgia
MD
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ABSTRACT

Background The Short Form-12 (SF-12) was developed as a shorter version of the SF-36, yet there has been limited validation of its reliability at measuring postoperative changes. The purpose of this study was to determine if the SF-12 could safely substitute for the SF-36 in measuring postoperative change in lumbar spine surgery patients and if the condition specific (Oswestry Disability Index [ODI]) or pain (visual analog scale [VAS]) instruments, provided additional utility.

Methods A total of 972 patients from a single center who underwent lumbar spine surgery for a predominant symptom of radiating leg pain with (n = 237) or without (n = 735) fusion and prospectively completed both SF-36 and ODI instruments before and after surgery were included. The SF-12 score was calculated from the appropriate subset of SF-36 responses. The absolute sensitivity and the intraclass correlation coefficient were calculated. Reliability of each instrument to measure preoperative to postoperative change was calculated as the standardized response mean.

Results The SF-12 and SF-36 demonstrated a strong correlation with each other ([0.97, P < .001] and [0.93, P < .001], respectively) preoperatively and postoperatively. The SF-12 and SF-36 scores were moderately to strongly inversely correlated with the ODI. The ODI showed greater reliability at measuring change than the SF-12 for both fusion (0.94 versus 0.72) and nonfusion (0.81 versus 0.33) lumbar surgery patients.

Conclusions The SF-12 was as effective as the SF-36 to measure general health status in lumbar spine surgery patients, and both were moderate to strong predictors of ODI preoperatively and postoperatively, but lack the reliability to detect change seen with the ODI or VAS after surgical intervention.

Level of Evidence 3.

Clinical Relevance These data suggest that the SF-12 is a valid substitute for the SF-36 to measure postoperative outcomes changes, but that the ODI should continue to be used to measure condition specific changes in function.

  • lumbar spine surgery
  • patient reported outcomes
  • Oswestry Disability Index
  • SF-12
  • SF-36
  • visual analog scale
  • quality of life
  • health status

Footnotes

  • Disclosures and COI: No funds were received in support of this study. Emory Institutional Review Board approval was received for this study.

  • ©International Society for the Advancement of Spine Surgery
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International Journal of Spine Surgery: 19 (S2)
International Journal of Spine Surgery
Vol. 19, Issue S2
1 Apr 2025
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Rational Selection of Patient-Reported Outcomes Measures in Lumbar Spine Surgery Patients
Susanne H. Boden, Kevin X. Farley, Collier Campbell, Scott D. Boden, Michael B. Gottschalk
International Journal of Spine Surgery Jun 2020, 7046; DOI: 10.14444/7046

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Rational Selection of Patient-Reported Outcomes Measures in Lumbar Spine Surgery Patients
Susanne H. Boden, Kevin X. Farley, Collier Campbell, Scott D. Boden, Michael B. Gottschalk
International Journal of Spine Surgery Jun 2020, 7046; DOI: 10.14444/7046
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Keywords

  • lumbar spine surgery
  • patient reported outcomes
  • oswestry disability index
  • SF-12
  • sf-36
  • visual analog scale
  • quality of life
  • health status

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