Outcome Assessment in Lumbar Spine Surgery

Gustavo Zanoli

Research output: ThesisDoctoral Thesis (compilation)

44 Citations (SciVal)


No consensus regarding outcomes assessment in spine patients exists. Health-Related Quality of Life (HRQoL) questionnaires are increasingly used. The objective of this thesis was the evaluation of HRQoL measures before and after lumbar spine surgery, and their relation to other evaluation parameters as well as relevance of differences.

The patients included were operated on for lumbar spine disorders at the Lund University, Department of Orthopedics and included in the Swedish National Lumbar Spine Registry. Baseline (before surgery) data include age, sex, smoking habits, duration of preoperative back and leg pain as well as sick leave, number of previous operations, and working status. Pre- and postoperatively VAS pain scores and the SF-36 questionnaire on HRQoL are registered as well as analgesic intake, walking distance and at follow-up change in leg and back pain as well as patient satisfaction.

The number of proposed outcome instruments is too high and a consensus on best HRQoL is required. The data collection protocol of the Swedish National Lumbar Spine Registry can reliably detect postoperative improvements between large groups of patients. Pain intensity measured on the VAS scale correlates significantly to other indicators of perceived pain. HRQoL as measured by SF-36 showed a pronounced reduction compared to healthy and LBP population preoperatively. One year after surgery improvement in all domains of the SF-36 except general health was seen. The global effect of lumbar spine surgery in the sample is similar to effect sizes of other successful orthopaedic interventions. The use of standardized outcome measures allows international comparisons, although caution should be used in the interpretation of differences.
Original languageEnglish
Awarding Institution
  • Orthopaedics (Lund)
  • Strömqvist, Björn, Supervisor
Award date2005 May 25
ISBN (Print)91-85439-47-9
Publication statusPublished - 2005

Bibliographical note

Defence details

Date: 2005-05-25
Time: 09:15
Place: Föreläsningssal F3 Centralblocket Universitetssjukhuset i Lund

External reviewer(s)

Name: Németh, Gunnar
Title: Professor
Affiliation: Stockholm


<div class="article_info">G Zanoli, B Strömqvist, R Padua and E Romanini. <span class="article_issue_date">2000</span>. <span class="article_title">Lessons learned searching for a HRQoL instrument to assess the results of treatment in persons with lumbar disorders.</span> <span class="journal_series_title">Spine</span>, <span class="journal_volume">vol 15:25</span> <span class="journal_pages">pp 3178-85</span>.</div>
<div class="article_info">G Zanoli, LT Nilsson and B Strömqvist. <span class="article_issue_date"></span>. <span class="article_title">Reliability of the prospective data collection protocol of the Swedish Spine Register: Test-retest analysis of 119 patients.</span> <span class="journal_series_title">Acta Orthop</span>, (submitted)</div>
<div class="article_info">G Zanoli, B Strömqvist and B Jönsson. <span class="article_issue_date">2001</span>. <span class="article_title">Visual analog scales for interpretation of back and leg pain intensity in patients operated for degenerative lumbar spine disorders.</span> <span class="journal_series_title">Spine</span>, <span class="journal_volume">vol 1:26</span> <span class="journal_pages">pp 2375-80</span>.</div>
<div class="article_info">G Zanoli, B Jönsson and B Strömqvist. <span class="article_issue_date"></span>. <span class="article_title">SF-36 scores in degenerative lumbar spine disorders: Analysis of prospective data from 451 patients.</span> <span class="journal_series_title">Spine</span>, (submitted)</div>
<div class="article_info">G Zanoli, B Jönsson and B Strömqvist. <span class="article_issue_date"></span>. <span class="article_title">Outcome assessment of spine surgery using the SF-36 questionnaire.</span> <span class="journal_series_title">Spine</span>, (submitted)</div>
<div class="article_info">G Zanoli, KY Hsu, JF Zucherman and B Strömqvist. <span class="article_issue_date"></span>. <span class="article_title">SF-36 profiles before and one year after spinal stenosis surgery - a comparison of two techniques in two nations.</span> <span class="journal_series_title">Spine</span>, (submitted)</div>

Subject classification (UKÄ)

  • Orthopedics


  • traumatologi
  • Surgery
  • Skeleton
  • muscle system
  • rheumatology locomotion
  • Skelett
  • muskelsystem
  • reumatologi
  • Spinal stenosis
  • Disc
  • Questionnaire
  • Outcome assessment
  • Lumbar spine
  • Kirurgi
  • traumatology
  • orthopaedics
  • ortopedi


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