Assessing outcome in lumbar disc surgery using patient completed measures

Measuring outcome after spinal surgery is difficult. The objective of this study was to assess the use of four measures in establishing outcome in pat ients undergoing lumbar discectomy. Forty-six consecutive patients who had undergone two operations for lumbar disc prolapse and 54 patients who had u ndergone one operation for the same condition over the same period were ide ntified. The SF-36 questionnaire was used to assess general health. The Rol and-Morris questionnaire and a simple modification of the Roland-Morris que stionnaire were used to assess back and leg related disability, respectivel y. Analogue pain scales were used to measure back pain and sciatica. The SF -36 scores revealed significantly worse health status in the two operation compared with the one operation patients and in all patients compared with the normal population. Using the Roland-Morris and the leg disability quest ionnaires, patients who had undergone two operations reported significantly worse disability (Roland-Morris, 53%, poor outcome) than those who had und ergone one operation (Roland-Morris, 19%, poor outcome). There was signific antly greater back disability than leg disability in both groups of patient s and this was confirmed by the analogue pain scales. In patients who had u ndergone two operations, 25% classified their back pain as very bad or unbe arable, and 22.5% described very bad or unbearable leg pain. For the one op eration patients these figures were 9.5 and 2.4%, respectively. The results demonstrate that both generic and condition specific patient completed mea sures have the potential to detect differences in outcome between patients who have undergone either one or two lumbar disc operations. The study prov ides support for the use of these patient completed measures in assessing o utcome in lumbar disc surgery.