Comparative responsiveness of four visual analogue scales in microdiscectomy for lumbar disc herniation
- 29 Downloads
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.
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.
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.
We recommend the use of VAS-LP-Severe as the most responsive VAS measure when evaluating the results of discectomy surgery for sciatica.
KeywordsResponsiveness Lumbar disc herniation Discectomy Visual analogue scale (VAS)
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.
- 9.Bolton JE, Wilkinson RC (1998) Responsiveness of pain scales: a comparison of three pain intensity measures in chiropractic patients. J Manip Physiol Ther 21:1–7Google Scholar
- 16.Turner JA, Fulton-Kehoe D, Franklin G, Wickizer TM, Wu R (2003) Comparison of the Roland–Morris Disability Questionnaire and generic health status measures: a population-based study of workers’ compensation back injury claimants. Spine (Phila Pa 1976) 28:1061–1067Google Scholar
- 17.Parker SL, Adogwa O, Paul AR, Anderson WN, Aaronson O, Cheng JS, McGirt MJ (2011) Utility of minimum clinically important difference in assessing pain, disability and health state after transforaminal lumbar interbody fusion for degenerative lumbar spondylolisthesis. J Neurosurg Spine 14:598–604CrossRefGoogle Scholar
- 20.Parker SL, Mendenhall SK, Shau DN, Adogwa O, Anderson WN, Devin CJ, McGirt MJ (2012) Minimum clinically important difference in pain, disability, and quality of life after neural decompression and fusion for same level recurrent lumbar stenosis: understanding clinical versus statistical significance. J Neurosurg Spine 16:471–478CrossRefGoogle Scholar