title: The Prolo Scale: history, evolution and psychometric properties.
abstract: BACKGROUND
  The Prolo Scale (PS) is a widely accepted assessment tool for lumbar spinal surgery results. Nevertheless, in the literature there is a dearth of consensus about its application, interpretation and accuracy. The purpose of this review is to investigate the evolution of the PS from its introduction in 1986 to the present, including an analysis of different versions of the scale and research on the existing studies investigating its psychometric properties.
  
  
  METHODS
  PubMed, Cochrane Library and PEDro databases were searched. Studies in English, Italian, French, Spanish and German published from 1986 to December 2012 were analyzed.
  
  
  RESULTS
  The original lumbar surgery outcome scale consisted of two Likert-type scales (economic and functional). There are three more versions of the scale: Schnee proposed one consisting of 10 items, Brantigan made one with 20 items and introduced 2 more subscales (pain and medication), and Davis adapted the scale for the cervical spine. PS is often mentioned without any specific reference to the version used; therefore, a homogeneous comparison of studies is difficult to achieve. Several authors agree on the need to embrace a multidimensional measuring system to evaluate low back pain (LBP), but there is still no consensus regarding the most reliable tool. To date, PS has been mostly used as secondary outcome measure in association with validated primary measures for LBP.
  
  
  CONCLUSIONS
  The Prolo Scale has been adopted for clinical examination for 20 years because it is easy to administer and useful to compare significant amounts of data from surgical studies carried out at different times. Although several authors demonstrated the scale sensitivity among a battery of tests, no thorough validation study was found in the current literature.
authors: University of Bologna, Bologna, Italy.
authors: Carla
authors: C
authors: Vanti
authors: Donatella
authors: D
authors: Prosperi
authors: Marco
authors: M
authors: Boschi
mesh_terms: D049673:History, 20th Century; D049674:History, 21st Century; D006801:Humans; D017116:Low Back Pain / Q000266:history* / Q000601:surgery; D009985:Orthopedics / Q000266:history*; D017063:Outcome Assessment, Health Care / Q000266:history* / Q000379:methods; D011594:Psychometrics / Q000266:history* / Q000379:methods; D013123:Spinal Fusion / Q000266:history*
references: Spine (Phila Pa 1976). 2003 Sep 1;28(17):1913-21
references: 12973134
references: Spine (Phila Pa 1976). 2000 Jun 1;25(11):1437-46
references: 10828927
references: J Neurosurg. 1999 Oct;91(2 Suppl):186-92
references: 10505503
references: Neurosurgery. 2002 Jun;50(6):1253-9; discussion 1259-60
references: 12015843
references: Croat Med J. 2001 Feb;42(1):49-53
references: 11172655
references: Spine (Phila Pa 1976). 1993 Oct 15;18(14):2106-7
references: 8272967
references: J Neurosurg Spine. 2004 Jul;1(1):19-23
references: 15291015
references: J Neurosurg Spine. 2004 Jul;1(1):58-63
references: 15291022
references: Eur Spine J. 2007 Apr;16(4):495-500
references: 16944228
references: J Spinal Disord Tech. 2002 Feb;15(1):16-23
references: 11891446
references: BMC Musculoskelet Disord. 2006 May 13;7:42
references: 16696861
references: Eur Spine J. 1997;6(3):173-80
references: 9258635
references: Surg Neurol. 2000 Aug;54(2):101-6; discussion 106-8
references: 11077091
references: Neurosurg Focus. 2006 Mar 15;20(3):E4
references: 16599420
references: Neurosurgery. 1992 Jun;30(6):862-6
references: 1614587
references: J Korean Neurosurg Soc. 2009 Oct;46(4):305-11
references: 19893717
references: J Bone Joint Surg Am. 1971 Jul;53(5):891-903
references: 4326746
references: J Spinal Disord Tech. 2003 Apr;16(2):150-5
references: 12679669
references: Spine (Phila Pa 1976). 2005 Feb 1;30(3):365-8
references: 15682021
references: J Am Med Assoc. 1958 Jan 4;166(1):23-8
references: 13491305
references: Z Orthop Unfall. 2009 Sep-Oct;147(5):588-92
references: 19806526
references: Pain. 2006 May;122(1-2):145-55
references: 16545523
references: Spine (Phila Pa 1976). 2000 Dec 15;25(24):3100-3
references: 11124724
references: J Neurosurg Spine. 2008 Dec;9(6):560-5
references: 19035748
references: BMJ. 2008 Jun 14;336(7657):1355-8
references: 18502911
references: J Neurosurg Spine. 2005 Mar;2(3):271-8
references: 15796351
references: Spine (Phila Pa 1976). 1986 Jul-Aug;11(6):601-6
references: 3787326
references: Clin Orthop Relat Res. 1981 Jan-Feb;(154):90-6
references: 7009017
references: Spine (Phila Pa 1976). 2006 May 20;31(12):1372-9; discussion 1380
references: 16721302
references: Arch Orthop Trauma Surg. 2010 May;130(5):591-7
references: 19565252
references: Spine (Phila Pa 1976). 1985 Nov;10(9):804-5
references: 4089654
references: Surg Neurol. 1996 Dec;46(6):523-30; discussion 530-3
references: 8956883
references: J Neurosurg Spine. 2010 Mar;12(3):320-6
references: 20192634
references: Spine (Phila Pa 1976). 2006 Aug 15;31(18):E636-40
references: 16915079
references: J Neurosurg. 1997 Jan;86(1):48-55
references: 8988081
references: Spine J. 2011 Jan;11(1):64-72
references: 21168100
references: JAMA. 1992 Aug 19;268(7):907-11
references: 1640622
references: Eur Spine J. 2009 Aug;18 Suppl 3:367-73
references: 19319578
references: Acta Neurochir (Wien). 2009 Mar;151(3):199-206
references: 19229467
references: Spine J. 2006 Jul-Aug;6(4):421-7
references: 16825050
references: Eur Spine J. 2011 May;20 Suppl 1:S46-56
references: 21404031
references: Ann Surg. 1931 Feb;93(2):563-86
references: 17866510
references: Surg Neurol. 2004 Nov;62(5):378-85, discussion 385-6
references: 15518835
references: Spine J. 2007 Sep-Oct;7(5):516-24
references: 17905313
references: Neurosurgery. 2004 Feb;54(2):368-74; discussion 374
references: 14744283
references: Eur Spine J. 2009 Jun;18 Suppl 1:40-8
references: 19396475
references: Indian J Orthop. 2009 Oct;43(4):347-51
references: 19838384
references: Clin Orthop Surg. 2009 Dec;1(4):214-21
references: 19956479
references: J Neurosurg Spine. 2007 Nov;7(5):496-502
references: 17977190
references: Spine (Phila Pa 1976). 1994 Sep 1;19(17):1909-14; discussion 1915
references: 7997923
references: Spine (Phila Pa 1976). 1998 Sep 15;23(18):2003-13
references: 9779535
references: J Neurosurg. 1994 Mar;80(3):415-21
references: 8113853
references: Eur Spine J. 2007 Dec;16(12):2096-103
references: 17922150
references: Eur Spine J. 2006 Nov;15(11):1653-60
references: 16369830
references: J Neurosurg. 2002 Oct;97(3 Suppl):281-6
references: 12408380
references: Turk Neurosurg. 2009 Apr;19(2):113-20
references: 19431119
references: Hippokratia. 2010 Jul;14(3):176-84
references: 20981166
references: Eur Spine J. 2007 Oct;16(10):1650-8
references: 17520298
references: BMJ. 2011 May 19;342:d2786
references: 21596740
references: J Bone Joint Surg Br. 2001 Sep;83(7):949-53
references: 11603533
references: Arq Neuropsiquiatr. 2007 Sep;65(3B):764-70
references: 17952277
references: J Neurosurg Spine. 2006 Jul;5(1):9-17
references: 16850951
references: J Spinal Disord Tech. 2010 Oct;23(7):444-50
references: 20921872
references: Eur Spine J. 2012 Jan;21(1):130-7
references: 21881865
references: SAS J. 2009 Sep 01;3(3):100-7
references: 25802633
references: Minim Invasive Neurosurg. 2010 Apr;53(2):60-4
references: 20549602
references: Spine (Phila Pa 1976). 2000 Oct 15;25(20):2656-62
references: 11034652
references: J Neurosurg. 1997 Jan;86(1):56-63
references: 8988082
references: Spine (Phila Pa 1976). 2008 Feb 1;33(3):E66-72
references: 18303447
references: Neurosurg Focus. 2001 Apr 15;10(4):E9
references: 16732636