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Open Access Research article

Accuracy and reproducibility of a retrospective outcome assessment for lumbar spinal stenosis surgery

Pekka Kuittinen1*, Timo Juhani Aalto23, Tapani Heikkilä4, Ville Leinonen5, Sakari Savolainen5, Petri Sipola6, Heikki Kröger7, Veli Turunen8 and Olavi Airaksinen4

Author Affiliations

1 Department of Neurosurgery, Kuopio University Hospital, Kuopio, Finland

2 Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland

3 Kyyhkylä Rehabilitation Center and Hospital, Mikkeli, Finland

4 Department of Physical and Rehabilitation Medicine, Kuopio University Hospital, Kuopio, Finland

5 Department of Neurosurgery, Kuopio University Hospital, Kuopio, Finland

6 Department of Clinical Radiology, University of Eastern Finland and Kuopio University Hospital, Kuopio, Finland

7 Department of Orthopaedics and Traumatology, Kuopio University Hospital and Bone and Cartilage Research Unit, University of Eastern Finland, Kuopio, Finland

8 Department of Orthopaedics and Traumatology, Kuopio University Hospital, Kuopio, Finland

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BMC Musculoskeletal Disorders 2012, 13:83  doi:10.1186/1471-2474-13-83

Published: 29 May 2012

Abstract

Background

Retrospective assessment of surgery outcome is considered problematic. The aims of this study were to evaluate the reproducibility and accuracy of a retrospective outcome assessment of lumbar spinal stenosis surgery with reference to prospective outcome scale measurements.

Method

Outcome of surgery from 100 lumbar spinal stenosis (LSS) patients was evaluated retrospectively from patient files of a 3-month outpatient visit performed according to a standard clinical protocol by two independent researchers. In the retrospective analysis, outcome was graded as 2 = good if the clinical condition had clearly improved, 1 = moderate if it had just slightly improved, 0 = poor if it had not improved or was even worse than before the surgical treatment (Retrospective 3- point scale). A prospectively assessed Oswestry Disability Index questionnaire (ODI), Visual analogue pain scale (VAS) and a patient satisfaction questionnaire were used as references of standards. Reproducibility of the measurements was evaluated.

Results

The retrospective 3-point scale correlated with ODI (r = 0.528; P < 0.001) and VAS (r = 0.368; P < 0.001). The agreement was better in the good and poor outcome than in the moderate outcome. Retrospective 3-point scale demonstrated substantial intra-rater and inter-rater repeatability (κ = 0.682, P < 0.001 and κ = 0.630, P < 0.001, respectively).

Conclusions

Retrospective assessment of spinal surgery outcome is highly reproducible. Accuracy is highest in the patients with poor and good surgical result.

Keywords:
Lumbar spinal stenosis; Surgical treatment; Outcome measures