The Rothman Institute at Thomas Jefferson University, Philadelphia, PA.
Spine (Phila Pa 1976). 2018 Jun 1;43(11):805-812. doi: 10.1097/BRS.0000000000002459.
A retrospective review.
The purpose of this study is to determine the differential improvement of the various individual items of the Oswestry Disability Index (ODI) and to determine their relationship to other measures of Health Related Quality of Life (HRQOL).
The ODI is an easily scored, common, 10-item questionnaire about symptoms relevant to lumbar spine pathology. It is not clear if all of the items can be reliably applied to spine surgery. The purpose of this study is to determine the differential improvement of the various individual items of the ODI and to determine their relationship to other measures of HRQOL.
Analysis of a prospective registry of patients treated at an academic medical center was undertaken. At baseline, standardized outcome measures including ODI and SF12 PCS were collected on all patients undergoing elective fusion surgery for degenerative spondylolisthesis. Multiple linear regressions were performed using change in SF12 PCS as the dependent variable and change in ODI components as the independent variables.
Baseline and 1-year follow-up data were collected on 196 patients (mean age 60.4 years). There were statistically significant differences in improvement among ODI items. Surprisingly, the most improvement after surgery was noted in the standing, sex life, and social life domains. The least improvement was noted in the personal care, sleeping, and sitting domains. Linear regression for change in ODI components versus change in SF-12 PCS revealed a significant correlation (R = 0.353, P ≤ 0.001). The only retained domains in the final model were change in lifting, standing, and traveling as predictors for ΔPCS.
All domains of the ODI do not improve equally after surgery for degenerative spondylolisthesis. Some of the domains that improve most (e.g., sex life) have no discernible relationship to the known pathophysiology of degenerative spondylolisthesis. Based upon these results, we conclude that the item bank and composite scoring of the ODI are inappropriate for evaluating quality of life in studies of surgically treated degenerative spondylolisthesis patients.
回顾性研究。
本研究旨在确定 Oswestry 功能障碍指数（ODI）各项的差异改善情况，并确定其与健康相关生活质量（HRQOL）其他测量指标的关系。
ODI 是一种简便评分的常用问卷，共 10 个项目，涉及与腰椎病理相关的症状。目前尚不清楚所有项目是否都能可靠地应用于脊柱手术。本研究旨在确定 ODI 各项的差异改善情况，并确定其与 HRQOL 其他测量指标的关系。
对学术医疗中心接受治疗的患者前瞻性登记进行分析。在基线时，对所有接受退行性脊椎滑脱融合手术的患者收集了包括 ODI 和 SF12 PCS 在内的标准化结局测量指标。使用 SF12 PCS 变化作为因变量，ODI 各组成部分的变化作为自变量进行多元线性回归。
共收集了 196 例患者的基线和 1 年随访数据（平均年龄 60.4 岁）。ODI 各项的改善程度存在统计学差异。出乎意料的是，术后改善最明显的领域是站立、性生活和社会生活。改善最不明显的领域是个人护理、睡眠和坐姿。ODI 各组成部分变化与 SF-12 PCS 变化的线性回归显示出显著相关性（R=0.353，P≤0.001）。最终模型中保留的唯一领域是提升、站立和旅行的变化，作为 PCS 的预测因子。
退行性脊椎滑脱融合术后，ODI 的所有领域改善程度并不相同。一些改善最明显的领域（如性生活）与退行性脊椎滑脱的已知病理生理学无明显关系。基于这些结果，我们得出结论，在评估接受手术治疗的退行性脊椎滑脱患者生活质量的研究中，ODI 的项目库和综合评分不适用。
3。
