Minimum Clinically Important Differences in Oswestry Disability Index Domains and Their Impact on Adult Spinal Deformity Surgery.
Minimum Clinically Important Differences in Oswestry Disability Index Domains and Their Impact on Adult Spinal Deformity Surgery.
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DOI：
10.31616/asj.2018.0077
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发表时间：
2019-03
影响因子：
2.3
通讯作者：
Matsuyama Y
中科院分区：
文献类型：
--
作者：
Yoshida G;Hasegawa T;Yamato Y;Kobayashi S;Shin O;Banno T;Mihara Y;Arima H;Ushirozako H;Yasuda T;Togawa D;Matsuyama Y
回顾性研究。计算 Oswestry 残疾指数 (ODI) 总范围和单个范围的最小临床重要差异 (MCID)，并评估接受手术治疗的成人脊柱畸形 (ASD) 患者的评分分布和随时间的变化。尽管 ODI 普遍用于评估 ASD，但尚无可靠的研究定义该指数的 MCID 值。这项研究包括 240 名连续的 ASD 患者，并进行了至少 2 年的随访。我们使用脊柱侧凸研究协会-22R 问卷的全部或部分作为锚定，计算了总和单个 ODI 域的 MCID 值。使用当前的 MCID 值，我们测量了随访时获得 MCID 的患者在总体 ODI 领域和个体 ODI 领域的获得率。分析了上下仪器椎骨的病理学、年龄和位置的差异。 ODI 总分的 MCID 为 11%，曲线下面积为 0.737。每个域的范围从 0 到 2，其中 1 是最常见的值。在疼痛和站立领域，>60% 的患者获得 MCID，尽管个人护理、举重、睡眠和性活动领域的获得率相对较低 (20%–35%)。与无 MCID 的患者相比，患有 MCID 的患者在腰椎前凸、矢状垂直轴和 T1 骨盆角方面的影像学改善更多（p<0.05）。据我们所知，这是第一个描述 ASD 手术后 ODI (11%) MCID 的研究。在疼痛和站立领域，大多数患者获得了 MCID，尽管在个人护理、举重、睡眠和性活动领域获得 MCID 的比率较低。脊柱外科医生应该向患者提供有关自闭症谱系障碍手术的好处和缺点的咨询。
Retrospective study. To calculate the minimum clinically important difference (MCID) for total and individual domains of the Oswestry Disability Index (ODI) and assess score distribution and changes over time in surgically treated adult spinal deformity (ASD) patients. Despite the common use of ODI for assessing ASD, there are no robust studies defining MCID values for this index. This study included 240 consecutive ASD patients with a minimum of 2 years of follow-up. We calculated MCID values for total and individual ODI domains using all or part of the Scoliosis Research Society-22R questionnaire as anchors. Using current MCID values, we measured the acquisition rates in patients who acquired MCID at follow-up in both total and individual ODI domains. Differences in pathology, age, and locations of the upper and lower instrumented vertebrae were analyzed. MCID of the total ODI score was 11%, with an area under the curve of 0.737. Each domain ranged from 0 to 2, with 1 being the most common value. In the pain and standing domains, >60% of the patients acquired MCID, although acquisition rates of the personal care, lifting, sleep, and sexual activity domains were relatively low (20%–35%). Patients with MCID had more radiographic improvement in lumbar lordosis, sagittal vertical axis, and T1 pelvic angle than those without MCID (p<0.05). To our knowledge, this is the first study to describe MCID of ODI (11%) after ASD surgery. In the pain and standing domains, most patients acquired MCID although the rates of acquisition of MCID in the personal care, lifting, sleep, and sexual activity domains were low. Spine surgeons should counsel their patients regarding the benefits and setbacks of ASD surgery.