Department of Neurosurgery, Kuopio University Hospital, Kuopio, Finland.
BMC Musculoskelet Disord. 2012 May 29;13:83. doi: 10.1186/1471-2474-13-83.
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.
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.
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).
Retrospective assessment of spinal surgery outcome is highly reproducible. Accuracy is highest in the patients with poor and good surgical result.
回顾性评估手术结果被认为存在问题。本研究旨在评估腰椎管狭窄症手术的回顾性结果评估与前瞻性结果量表测量的重现性和准确性。
根据标准临床方案，由两名独立研究人员从术后 3 个月门诊的患者档案中回顾性评估 100 例腰椎管狭窄症（LSS）患者的手术结果。在回顾性分析中，如果临床状况明显改善，则将结果评为 2=良好，如果仅略有改善，则评为 1=中度，如果没有改善或甚至比手术治疗前更差，则评为 0=差（回顾性 3 分量表）。前瞻性评估的 Oswestry 残疾指数问卷（ODI）、视觉模拟疼痛量表（VAS）和患者满意度问卷作为标准参考。评估了测量的重现性。
回顾性 3 分量表与 ODI（r=0.528；P<0.001）和 VAS（r=0.368；P<0.001）相关。在良好和较差的结果中，一致性优于中等结果。回顾性 3 分量表显示出较高的内部和外部评分者重复性（κ=0.682，P<0.001 和 κ=0.630，P<0.001）。
脊柱手术结果的回顾性评估具有高度可重复性。在手术结果差和良好的患者中准确性最高。
