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Spine Scores

Score systems for spinal disorders are used to evaluate the disease severity and to measure the outcome objectively. The use of spinal scales could enable us to:

1. Evaluate and grade the disease objectively.

2. Develop algorithms for treatment selection.

3. Measure the outcome, treatment effectiveness.

4. Communicate better.

Many of spinal scales are for outcome assessment. Outcome assessment is complex and involves multiple dimensions including symptoms, general well-being, function, work disability, and satisfaction with treatment. A scale system should conform some standards in terms of reliability, validity, responsiveness, and practicality of the measures.

Minimum Clinically Important Difference

Treatment effectiveness following spine surgery is usually measured using patient-reported outcome (PRO) questionnaires such as VAS, Oswestry Disability Index and SF-36. Although these questionnaires assess pain, disability and general health state, their numerical scores lack a direct, clinically significant meaning. Thus, the concept of minimum clinically important difference (MCID) has been introduced which indicates the smallest change in an outcome measure which is important to patients. If treatment effects reach MCID threshold value, it implies that the treatment is clinically significant and justifies its implementation in clinical practice.

Pain Diagram

Pain Diagram

Low Back

Nomenclature & Classification of Lumbar Disc Pathology

Nomenclature & Classification of Lumbar Disc Pathology

Recommendations of the Combined Task Force of the North American Spine Society, American Society of Spine Radiology, and American Society of Neuroradiology. By David F. Fardon, MD and Pierre C. Milette, MD.

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