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Responsiveness of the Zurich Claudication Questionnaire, the Oswestry Disability Index, the Japanese Orthopaedic Association Back Pain Evaluation Questionnaire, the 8-Item Short Form Health Survey, and the Euroqol 5 dimensions 5 level in the assessment of patients with lumbar spinal stenosis

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Abstract

Purpose

To assess the responsiveness of the Zurich Claudication Questionnaire (ZCQ), the Oswestry Disability Index, the Japanese Orthopaedic Association Back Pain Evaluation Questionnaire, the visual analog scale (VAS), the 8-Item Short Form Health Survey (SF-8), and the EuroQol 5 dimensions 5 level as methods of assessing outcomes of surgery for lumbar spinal stenosis.

Methods

We analyzed 218 patients who had undergone lumbar surgery for spinal stenosis and completed one year of follow-up. The internal responsiveness of each questionnaire and any domains was assessed by the effect size and standardized response mean. External responsiveness was assessed by the Spearman rank correlation coefficient and the receiver operating characteristics (ROC) curve.

Results

The most responsive assessments were “symptom severity” and “physical function” on the ZCQ, “walking ability” on the JOABPEQ, “leg pain” on the VAS, and “social function” on the JOABPEQ. The moderately responsive assessments were the physical component summary on the SF-8, the ODI, the EQ5D-5L, “low back pain” on the JOABPEQ, and “leg numbness” on the VAS. The least responsive assessments were “low back pain” on the VAS, “mental health” and “lumbar function” on the JOABPEQ, and the mental component summary on the SF-8.

Conclusions

Because of its high responsiveness, “symptom severity” on the ZCQ is recommended as a primary tool for assessing outcome when designing prospective studies for lumbar spinal stenosis.

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Funding

This work was supported by JSPS KAKENHI Grant Number JP21K20966.

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Authors and Affiliations

  1. Department of Orthopedic Surgery, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka, 565-0871, Japan

    Takahito Fujimori

  2. Department of Orthopedic Surgery, Japan Community Healthcare Organization Osaka Hospital, Osaka, Japan

    Takahito Fujimori, Daisuke Ikegami, Tsuyoshi Sugiura & Hironobu Sakaura

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  1. Takahito Fujimori
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  2. Daisuke Ikegami
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Correspondence to Takahito Fujimori.

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This study was approved by the institutional review board of Japan Community Healthcare Organization, Osaka Hospital (IRB 2018–52).

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Fujimori, T., Ikegami, D., Sugiura, T. et al. Responsiveness of the Zurich Claudication Questionnaire, the Oswestry Disability Index, the Japanese Orthopaedic Association Back Pain Evaluation Questionnaire, the 8-Item Short Form Health Survey, and the Euroqol 5 dimensions 5 level in the assessment of patients with lumbar spinal stenosis. Eur Spine J 31, 1399–1412 (2022). https://doi.org/10.1007/s00586-022-07236-5

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