The predictive value of the baseline Oswestry Disability Index in lumbar disc arthroplasty.
OBJECTIVE
The goal of the study was to determine patient factors predictive of good outcome after lumbar disc arthroplasty. Specifically, the paper examines the relationship of the preoperative Oswestry Disability Index (ODI) to patient outcome at 1 year.


METHODS
The study is a retrospective review of 20 patients undergoing a 1-level lumbar disc arthroplasty at the author's institution between 2004 and 2008. All data were collected prospectively. Data included the ODI, visual analog scale scores, and patient demographics.


RESULTS
All patients underwent a 1-level disc arthroplasty at L4-5 or L5-S1. The patients were divided into 2 groups based on their baseline ODI. Patients with an ODI between 38 and 59 demonstrated better outcomes with lumbar disc arthroplasty. Only 1 (20%) of 5 patients with a baseline ODI higher than 60 reported a good outcome. In contrast, 13 (87%) of 15 patients with an ODI between 38 and 59 showed a good outcome (p = 0.03). The negative predictive value of using ODI > 60 is 60% in patients who are determined to be candidates for lumbar arthroplasty.


CONCLUSIONS
Lumbar arthroplasty is very effective in some patients. Other patients do not improve after surgery. The baseline ODI results are predictive of outcome in patients selected for lumbar disc arthroplasty. A baseline ODI > 60 is predictive of poor outcome. A high ODI may be indicative of psychosocial overlay.
Deutsch
Harel
H
Department of Neurosurgery, Rush University Medical Center, Chicago, Illinois, USA. Harel_Deutsch@rush.edu
D000328:Adult; D001178:Arthroplasty / Q000295:instrumentation / Q000379:methods; D004185:Disability Evaluation; D017586:Diskectomy / Q000295:instrumentation / Q000379:methods; D005260:Female; D006801:Humans; D007403:Intervertebral Disc / Q000473:pathology / Q000503:physiopathology / Q000601:surgery; D007405:Intervertebral Disc Displacement / Q000175:diagnosis / Q000601:surgery*; D017116:Low Back Pain / Q000473:pathology / Q000503:physiopathology / Q000601:surgery; D008159:Lumbar Vertebrae / Q000503:physiopathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D010147:Pain Measurement; D018579:Patient Selection; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012189:Retrospective Studies; D055009:Spondylosis / Q000175:diagnosis / Q000601:surgery*; D016896:Treatment Outcome