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Patient-Reported Outcome Instruments in Spine Surgery.

Javier Z Guzman1, Holt S Cutler, James Connolly

  • 1*Department of Orthopaedic Surgery, Icahn School of Medicine at Mount Sinai, New York, NY †Department of Orthopaedic Surgery, Cleveland Clinic, Cleveland, OH ‡Department of Orthopaedic Surgery, Washington University School of Medicine, St. Louis, MO.

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Summary

Patient-reported outcome instruments (PROIs) are widely used in spine surgery research. A review found 206 unique PROIs, highlighting the need for standardized guidelines for their use in clinical practice.

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Area of Science:

  • Orthopedic Surgery
  • Clinical Research Methodology

Background:

  • Patient-reported outcome instruments (PROIs) are essential for evaluating treatment efficacy in spine surgery.
  • A lack of consensus exists regarding the selection of appropriate PROIs for specific spinal conditions and interventions.

Purpose of the Study:

  • To analyze the frequency, trends, and utilization methods of spine-related PROIs over a 10-year period (2004-2013).

Main Methods:

  • A comprehensive literature review of 5 major orthopedic journals was conducted.
  • Articles published between 2004 and 2013 focusing on spine surgery and including PROIs were analyzed.
  • Level of Evidence (LOE) 1-4 studies investigating surgical interventions were included.

Main Results:

  • Over 1,000 articles utilized PROIs, with most studies being LOE 4 (32.7%).
  • Degenerative thoracolumbar conditions were the most common focus (48.9%).
  • A wide array of 206 unique PROIs were identified, with the Visual Analog Scale, Oswestry Disability Index, and SF-36 being most frequent.

Conclusions:

  • The extensive variety of PROIs in spine surgery necessitates the development of clear guidelines.
  • Establishing a consensus on PROI selection for specific diagnoses and procedures is recommended to improve research consistency and clinical decision-making.