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Evaluation of health-related quality of life in patients candidate for spine and other musculoskeletal surgery

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Abstract

Introduction

Despite the high prevalence of musculoskeletal diseases, in Spain there are few data about how these conditions affect the quality of life of individuals. The objective of this study was to assess the quality of life (QOL) of patients candidate for orthopedic surgical treatment using an age–gender adjusted method of QOL scores.

Materials and methods

The SF-36 Health Survey was administered to 538 patients candidate for surgery between surgical treatment was classified in four groups (lumbar disease, cervical disease, knee arthroplasty, and hip arthroplasty). Associated morbidities were collected retrospectively for all cases using the Charlson co-morbidity index. Univariate, bivariate, and multivariate statistical analyses were done to compare the four groups to each other, to the general population mean, and to the age and gender-adjusted population mean.

Results

234 men and 304 women whose mean age was 58.78 years (19–89) were assessed. Patients candidate for some kind or lumbar surgery had the worst scores in all physical and mental scales as compared to the other disease groups. Patients candidate for knee arthroplasty, had the best quality of life scores in all scales, compared to the other disease groups. Medical conditions had no influence over the summary measures.

Conclusion

Presenting the results of SF-36 in standard deviations from the age- and gender-adjusted population mean (T values) leads to a better appreciation of the differences between the various diseases. Patients candidate for surgery of the lumbar spine had a worse QOL, while the QOL in patients candidate for knee arthroplasty was the least affected.

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References

  1. Alonso J, Prieto L, Anto JM (1995) The Spanish version of the SF-36 Health Survey (the SF-36 health questionnaire): an instrument for measuring clinical results. Med Clin (Barc) 104:771–776

    CAS  Google Scholar 

  2. Alonso J, Regidor E, Barrio G, Prieto L, Rodríguez C, de la Fuente L (1998) Population reference values of the Spanish version of the Health Questionnaire SF-36. Med Clin (Barc) 111:410–416

    CAS  Google Scholar 

  3. Bachmeier CJ, March LM, Cross MJ, Lapsley HM, Tribe KL, Courtenay BG, Brooks PM (2001) A comparison of outcomes in osteoarthritis patients undergoing total hip and knee replacement surgery. Osteoarthr Cartil 9:137–146

    Article  PubMed  CAS  Google Scholar 

  4. Bennett KJ, Torrance GW, Moran LA, Smith F, Goldsmith CH (1997) Health state utilities in knee replacement surgery: the development and evaluation of McKnee. J Rheumatol 24:1796–1805

    PubMed  CAS  Google Scholar 

  5. Bigos SJ, Battie MC, Spengler DM, Fisher LD, Fordyce WE, Hansson TH, Nachemson AL, Wortley MD (1991) A prospective study of work perceptions and psychosocial factors affecting the report of back injury. Spine 16:1–6

    Article  PubMed  CAS  Google Scholar 

  6. Blumenthal D (1996) Effects of market reforms on doctors and their patients. Health Aff (Millwood) 15:170–184

    Article  CAS  Google Scholar 

  7. Blumenthal D, Causino N, Campbell E, Louis KS (1996) Relationships between academic institutions and industry in the life sciences—an industry survey. N Engl J Med 334:368–373

    Article  PubMed  CAS  Google Scholar 

  8. Blumenthal D, Meyer GS (1996) Academic health centers in a changing environment. Health Aff (Millwood) 15:200–215

    Article  CAS  Google Scholar 

  9. Boos N, Rieder R, Schade V, Spratt KF, Semmer N, Aebi M (1995) 1995 Volvo Award in clinical sciences. The diagnostic accuracy of magnetic resonance imaging, work perception, and psychosocial factors in identifying symptomatic disc herniations. Spine 20:2613–2625

    Article  PubMed  CAS  Google Scholar 

  10. Carmona L, Ballina J, Gabriel R, Laffon A (2001) The burden of musculoskeletal diseases in the general population of Spain: results from a national survey. Ann Rheum Dis 60:1040–1045

    Article  PubMed  CAS  Google Scholar 

  11. Charlson ME, Pompei P, Ales KL, MacKenzie CR (1987) A new method of classifying prognostic comorbidity in longitudinal studies: development and validation. J Chronic Dis 40:373–383

    Article  PubMed  CAS  Google Scholar 

  12. Dahl B, Gehrchen PM, Kiaer T, Blyme P, Tondevold E, Bendix T (2001) Nonorganic pain drawings are associated with low psychological scores on the preoperative SF-36 questionnaire in patients with chronic low back pain. Eur Spine J 10:211–214

    Article  PubMed  CAS  Google Scholar 

  13. DeFriese GH (1990) Measuring the effectiveness of medical interventions: new expectations of health services research. Health Serv Res 25:691–695

    PubMed  CAS  Google Scholar 

  14. Derrett S, Paul C, Morris JM (1999) Waiting for elective surgery: effects on health-related quality of life. Int J Qual Health Care 11:47–57

    Article  PubMed  CAS  Google Scholar 

  15. Deyo RA, Cherkin DC, Ciol MA (1992) Adapting a clinical comorbidity index for use with ICD-9-CM administrative databases. J Clin Epidemiol 45:613–619

    Article  PubMed  CAS  Google Scholar 

  16. Deyo RA, Nachemson A, Mirza SK (2004) Spinal-fusion surgery—the case for restraint. N Engl J Med 350:722–726

    Article  PubMed  CAS  Google Scholar 

  17. Donabedian A (1981) Using decision analysis to formulate process criteria for quality assessment. Inquiry 18:102–119

    PubMed  CAS  Google Scholar 

  18. Fairbank JC, Couper J, Davies JB, O’Brien JP (1980) The Oswestry low back pain disability questionnaire. Physiotherapy 66:271–273

    PubMed  CAS  Google Scholar 

  19. Fanuele JC, Birkmeyer NJ, Abdu WA, Tosteson TD, Weinstein JN (2000) The impact of spinal problems on the health status of patients: have we underestimated the effect? Spine 25:1509–1514

    Article  PubMed  CAS  Google Scholar 

  20. Ferrer M, Alonso J (2005) Valores poblacionales por edad y sexo para los sumatorios físico y mental de la versión española del SF-36. Comunicación personal

  21. Fischgrund JS, Mackay M, Herkowitz HN, Brower R, Montgomery DM, Kurz LT (1997) 1997 Volvo Award winner in clinical studies. Degenerative lumbar spondylolisthesis with spinal stenosis: a prospective, randomized study comparing decompressive laminectomy and arthrodesis with and without spinal instrumentation. Spine 22:2807–2812

    Article  PubMed  CAS  Google Scholar 

  22. Frymoyer JW (1992) Predicting disability from low back pain. Clin Orthop Relat Res 279:101–109

    Google Scholar 

  23. Gabriel SE, Crowson CS, O’Fallon WM (1999) A comparison of two comorbidity instruments in arthritis. J Clin Epidemiol 52:1137–1142

    Article  PubMed  CAS  Google Scholar 

  24. Gartsman GM, Brinker MR, Khan M, Karahan M (1998) Self-assessment of general health status in patients with five common shoulder conditions. J Should Elbow Surg 7:228–237

    Article  CAS  Google Scholar 

  25. Gatchel RJ, Polatin PB, Kinney RK (1995) Predicting outcome of chronic back pain using clinical predictors of psychopathology: a prospective analysis. Health Psychol 14:415–420

    Article  PubMed  CAS  Google Scholar 

  26. Glassman SD, Minkow RE, Dimar JR, Puno RM, Raque GH, Johnson JR (1998) Effect of prior lumbar discectomy on outcome of lumbar fusion: a prospective analysis using the SF-36 measure. J Spinal Disord 11:383–388

    Article  PubMed  CAS  Google Scholar 

  27. Greenfield S, Apolone G, McNeil BJ, Cleary PD (1993) The importance of co-existent disease in the occurrence of postoperative complications and one-year recovery in patients undergoing total hip replacement. Comorbidity and outcomes after hip replacement. Med Care 31:141–154

    Article  PubMed  CAS  Google Scholar 

  28. Hozack WJ, Rothman RH, Albert TJ, Balderston RA, Eng K (1997) Relationship of total hip arthroplasty outcomes to other orthopaedic procedures. Clin Orthop Relat Res 344:88–93

    Google Scholar 

  29. Kantz ME, Harris WJ, Levitsky K, Ware JE Jr, Davies AR (1992) Methods for assessing condition-specific and generic functional status outcomes after total knee replacement. Med Care 30:MS240–MS252

    Article  PubMed  CAS  Google Scholar 

  30. Keller RB (1993) Outcomes research in orthopaedics. J Am Acad Orthop Surg 1:122–129

    PubMed  Google Scholar 

  31. Kelly KD, Voaklander DC, Johnston DW, Newman SC, Suarez-Almazor ME (2001) Change in pain and function while waiting for major joint arthroplasty. J Arthroplasty 16:351–359

    Article  PubMed  CAS  Google Scholar 

  32. Kelsey JL, White AA III (1980) Epidemiology and impact of low-back pain. Spine 5:133–142

    Article  PubMed  CAS  Google Scholar 

  33. Krishnan KR, France RD, Pelton S, McCann UD, Davidson J, Urban BJ (1985) Chronic pain and depression. II. Symptoms of anxiety in chronic low back pain patients and their relationship to subtypes of depression. Pain 22:289–294

    Article  PubMed  CAS  Google Scholar 

  34. Lieberman JR, Dorey F, Shekelle P, Schumacher L, Kilgus DJ, Thomas BJ, Finerman GA (1997) Outcome after total hip arthroplasty. Comparison of a traditional disease-specific and a quality-of-life measurement of outcome. J Arthroplasty 12:639–645

    Article  PubMed  CAS  Google Scholar 

  35. Lorish TR, Tanabe CT, Waller FT, London MR, Lansky DJ (1998) Correlation between health outcome and length of hospital stay in lumbar microdiscectomy. Spine 23:2195–2200

    Article  PubMed  CAS  Google Scholar 

  36. Matsen FA III (1996) Early effectiveness of shoulder arthroplasty for patients who have primary glenohumeral degenerative joint disease. J Bone Jt Surg Am 78:260–264

    Google Scholar 

  37. McHorney CA, Ware JE Jr, Raczek AE (1993) The MOS 36-Item Short-Form Health Survey (SF-36): II. Psychometric and clinical tests of validity in measuring physical and mental health constructs. Med Care 31:247–263

    Article  PubMed  CAS  Google Scholar 

  38. Murray D (1998) Surgery and joint replacement for joint disease. Acta Orthop Scand Suppl 281:17–20

    PubMed  CAS  Google Scholar 

  39. Nickel R, Egle UT, Rompe J, Eysel P, Hoffmann SO (2002) Somatisation predicts the outcome of treatment in patients with low back pain. J Bone Jt Surg Br 84:189–195

    Article  CAS  Google Scholar 

  40. Nilsdotter AK, Lohmander LS (2002) Age and waiting time as predictors of outcome after total hip replacement for osteoarthritis. Rheumatology (Oxford) 41:1261–1267

    Article  Google Scholar 

  41. Nork SE, Hu SS, Workman KL, Glazer PA, Bradford DS (1999) Patient outcomes after decompression and instrumented posterior spinal fusion for degenerative spondylolisthesis. Spine 24:561–569

    Article  PubMed  CAS  Google Scholar 

  42. Patrick DL, Deyo RA, Atlas SJ, Singer DE, Chapin A, Keller RB (1995) Assessing health-related quality of life in patients with sciatica. Spine 20:1899–1908

    Article  PubMed  CAS  Google Scholar 

  43. Pompei P, Charlson ME, Douglas RG Jr (1988) Clinical assessments as predictors of one year survival after hospitalization: implications for prognostic stratification. J Clin Epidemiol 41:275–284

    Article  PubMed  CAS  Google Scholar 

  44. Schlenk EA, Erlen JA, Dunbar-Jacob J, McDowell J, Engberg S, Sereika SM, Rohay JM, Bernier MJ (1998) Health-related quality of life in chronic disorders: a comparison across studies using the MOS SF-36. Qual Life Res 7:57–65

    Article  PubMed  CAS  Google Scholar 

  45. Singer MA, Hopman WM, MacKenzie TA (1999) Physical functioning and mental health in patients with chronic medical conditions. Qual Life Res 8:687–691

    Article  PubMed  CAS  Google Scholar 

  46. Spengler DM, Bigos SJ, Martin NA, Zeh J, Fisher L, Nachemson A (1986) Back injuries in industry: a retrospective study. I. Overview and cost analysis. Spine 11:241–245

    Article  PubMed  CAS  Google Scholar 

  47. Stansfeld SA, Smith GD, Marmot M (1993) Association between physical and psychological morbidity in the Whitehall II Study. J Psychosom Res 37:227–238

    Article  PubMed  CAS  Google Scholar 

  48. Taylor SJ, Taylor AE, Foy MA, Fogg AJ (1999) Responsiveness of common outcome measures for patients with low back pain. Spine 24:1805–1812

    Article  PubMed  CAS  Google Scholar 

  49. Taylor VM, Deyo RA, Cherkin DC, Kreuter W (1994) Low back pain hospitalization. Recent United States trends and regional variations. Spine 19:1207–1212

    Article  PubMed  CAS  Google Scholar 

  50. Tornero Molina J, Rodríguez Benito U, Massip M, Vidal Fuentes J, Fernández E (1992) Reumatic disease as the cause of permanent work disability in Spain. Rev Esp Reumatol 19:294–297

    Google Scholar 

  51. Volinn E, Turczyn KM, Loeser JD (1994) Patterns in low back pain hospitalizations: implications for the treatment of low back pain in an era of health care reform. Clin J Pain 10:64–70

    Article  PubMed  CAS  Google Scholar 

  52. Waddell G, Kummel EG, Lotto WN, Graham JD, Hall H, McCulloch JA (1979) Failed lumbar disc surgery and repeat surgery following industrial injuries. J Bone Jt Surg Am 61:201–207

    CAS  Google Scholar 

  53. Walsh TL, Hanscom B, Lurie JD, Weinstein JN (2003) Is a condition-specific instrument for patients with low back pain/leg symptoms really necessary? The responsiveness of the Oswestry Disability Index, MODEMS, and the SF-36. Spine 28:607–615

    PubMed  Google Scholar 

  54. Ware JE (1993) Measuring patients’ views: the optimum outcome measure. BMJ 306:1429–1430

    Article  PubMed  CAS  Google Scholar 

  55. Ware JE Jr, Sherbourne CD (1992) The MOS 36-item short-form health survey (SF-36). I. Conceptual framework and item selection. Med Care 30:473–483

    Article  PubMed  Google Scholar 

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Correspondence to José Antonio Becerra Fontal.

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Becerra Fontal, J.A., Bagó Granell, J., Garré Olmo, J. et al. Evaluation of health-related quality of life in patients candidate for spine and other musculoskeletal surgery. Eur Spine J 22, 1002–1009 (2013). https://doi.org/10.1007/s00586-012-2617-0

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  • DOI: https://doi.org/10.1007/s00586-012-2617-0

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