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Comparative responsiveness of four visual analogue scales in microdiscectomy for lumbar disc herniation

  • Karthik VishwanathanEmail author
  • Ian Braithwaite
Original Article • SPINE - MEDICAL STATISTICS
  • 29 Downloads

Abstract

Introduction

There is a paucity of studies reporting responsiveness of visual analogue scale (VAS) measures in patients treated by discectomy for symptomatic lumbar disc herniation. The aim of this study was to evaluate the responsiveness of different types of VAS.

Methods

VAS score was measured separately for constant leg pain (VAS-LP-constant), severe episode of leg pain (VAS-LP-severe), constant backache (VAS-BP-constant) and severe episode of backache (VAS-BP-severe) in a cohort of patients undergoing discectomy surgery for sciatica. VAS was evaluated preoperatively and postoperatively at final follow-up. Responsiveness was determined using standardised response mean (SRM), effect size (ES) and the area under the curve (AUC) analysis using receiver operating characteristic curves. For AUC analysis, the success of discectomy from the patient’s perspective was chosen as the external anchor.

Results

Ninety-eight patients were included in this prospective study. Outcome was assessed at a mean follow-up of 12 weeks postoperatively. The SRM of VAS-LP-severe, VAS-LP-constant, VAS-BP-severe and VAS-BP-constant was 2.16, 2.16, 0.87 and 0.53, respectively. The ES of VAS-LP-severe, VAS-LP-constant, VAS-BP-severe and VAS-BP-constant was 3.53, 2.70, 0.89 and 0.53, respectively. The AUC of VAS-LP-severe, VAS-LP-constant, VAS-BP-severe and VAS-BP-constant was 0.88, 0.75, 0.74 and 0.59, respectively.

Conclusion

We recommend the use of VAS-LP-Severe as the most responsive VAS measure when evaluating the results of discectomy surgery for sciatica.

Keywords

Responsiveness Lumbar disc herniation Discectomy Visual analogue scale (VAS) 

Notes

Author contributions

All authors were involved in conception and design and collected and assembled the data. Ian Braithwaite was involved in provision of patients. Ian Braithwaite provided administrative support. All authors analysed and interpreted the data. Karthik Vishwanathan was involved in manuscript drafting. Ian Braithwaite contributed to critical revision of the manuscript and supervision.

Compliance with ethical standards

Conflict of interest

Dr. Karthik Vishwanathan and Mr. Ian Braithwaite declare that they have no conflict of interest pertaining to the present manuscript.

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Copyright information

© Springer-Verlag France SAS, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of Orthopaedics, Charutar Arogya MandalShri Krishna Hospital and Pramukhswami Medical CollegeGokalnagar, KaramsadIndia
  2. 2.Nuffield hospitalChesterUK

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