Correlation Between the Oswestry Disability Index and the North American Spine Surgery Patient Satisfaction Index

Authors

Timothy J. Yee, Department of Neurosurgery, University of Michigan, Ann Arbor, Michigan, USA.
Kelsey J. Fearer, Department of Neurosurgery, University of Michigan, Ann Arbor, Michigan, USA.
Mark E. Oppenlander, Department of Neurosurgery, University of Michigan, Ann Arbor, Michigan, USA.
Osama N. Kashlan, Department of Neurosurgery, University of Michigan, Ann Arbor, Michigan, USA.
Nicholas Szerlip, Department of Neurosurgery, University of Michigan, Ann Arbor, Michigan, USA.
Martin J. Buckingham, Department of Neurosurgery, University of Michigan, Ann Arbor, Michigan, USA.
Kevin Swong, Department of Neurosurgery, University of Michigan, Ann Arbor, Michigan, USA.
Victor Chang, Department of Neurological Surgery, Henry Ford Health System, Detroit, Michigan, USA.
Jason M. Schwalb, Department of Neurological Surgery, Henry Ford Health System, Detroit, Michigan, USA.
Paul Park, Department of Neurosurgery, University of Michigan, Ann Arbor, Michigan, USA. Electronic address: ppark@med.umich.edu.

Document Type

Article

Abstract

BACKGROUND: The Oswestry Disability Index (ODI) is a widely used patient-reported outcome instrument in lumbar spine surgery, but its relationship to the increasingly scrutinized but still heterogeneous patient satisfaction metrics has not been well described. One popular metric is the North American Spine Society (NASS) patient satisfaction index. This study aimed to determine whether change in ODI predicts patient satisfaction. METHODS: Adult patients at a neurosurgery spine clinic completed the ODI and NASS questionnaires at various times in their care between September 2014 and November 2018. Scores were retrospectively analyzed using ordinal logistic regression. RESULTS: One thousand thirty-seven patients were identified (mean age 59.3 ± 14.7 years, 54.2% male). At 3, 12, and 24 months postoperatively, 684 (84.5%), 400 (83.3%), and 215 (80.9%) patients, respectively, expressed satisfaction (NASS score 1 or 2). Mean ± standard deviation improvements in ODI at 3, 12, and 24 months postoperatively were 16.8 ± 17.5 (n = 675), 18.4 ± 17.5 (n = 396), and 19.7 ± 17.7 (n = 213). For every unit improvement in ODI, the odds of selecting the next most satisfied NASS score at 3, 12, and 24 months postoperatively increased by 6.8% (95% confidence interval [CI] 5.6%-8.1%), 5.8% (95% CI 4.4%-7.1%), and 6.0% (95% CI 4.2%-7.9%), respectively. Every 10-unit improvement increased the odds, respectively, by 93.8% (95% CI 73.2%-117.0%), 75.0% (95% CI 53.8%-99.1%), and 79.4% (95% CI 50.3%-114.1%). CONCLUSIONS: Improvements in ODI are predictive of increased patient satisfaction as defined by the NASS index. A 10-point improvement in ODI nearly doubled the odds of increased satisfaction 3 months postoperatively.

Medical Subject Headings

Adult; Aged; Cross-Sectional Studies; Disability Evaluation; Female; Humans; Lumbar Vertebrae (surgery); Male; Middle Aged; Orthopedic Procedures; Patient Reported Outcome Measures; Patient Satisfaction; Retrospective Studies; Surveys and Questionnaires; Treatment Outcome

Publication Date

7-1-2020

Publication Title

World neurosurgery

E-ISSN

1878-8769

Volume

139

First Page

e724

Last Page

e729

PubMed ID

32344134

Digital Object Identifier (DOI)

10.1016/j.wneu.2020.04.117

Recommended Citation

Yee, Timothy J.; Fearer, Kelsey J.; Oppenlander, Mark E.; Kashlan, Osama N.; Szerlip, Nicholas; Buckingham, Martin J.; Swong, Kevin; Chang, Victor; Schwalb, Jason M.; and Park, Paul, "Correlation Between the Oswestry Disability Index and the North American Spine Surgery Patient Satisfaction Index" (2020). Neurosurgery. 1620.
https://scholar.barrowneuro.org/neurosurgery/1620