A modified Roland-Morris disability scale for the assessment of sciatica

Area of Science:

• Orthopedics
• Neurosurgery
• Pain Management

Background:

• The Roland-Morris Disability Scale (RMS) is widely used for low back pain disability.
• A modified version, RMS-L, was developed to enhance sensitivity to sciatica.
• Validation was performed in patients with lumbar disc prolapse and radiculopathy.

Purpose of the Study:

• To validate the modified RMS-L for assessing disability in patients with lumbar radiculopathy.
• To compare the sensitivity of RMS-L and the original RMS in detecting sciatica.
• To evaluate the correlation of both scales with generic health outcome measures.

Main Methods:

• Prospective administration of RMS and RMS-L to 203 patients with lumbar radiculopathy and disc prolapse.
• Comparison of scale scores with Visual Analogue Scores (VAS) for leg and back pain.
• Correlation analysis with Short Form 36 (SF-36) physical function and bodily pain domains at baseline and follow-up.

Main Results:

• RMS-L showed significantly greater correlation with VAS leg pain than RMS (pre-op and 3-month follow-up).
• RMS demonstrated higher correlation with VAS back pain compared to RMS-L.
• RMS-L correlated better with SF-36 physical function and bodily pain, with larger effect sizes.

Conclusions:

• The modified RMS-L effectively discriminates disability due to sciatica.
• The original RMS is suitable for assessing low back pain disability.
• Separate assessment of back pain and sciatica is valuable for surgical decision-making and outcome prediction.