Entwicklung und Validierung des VAS-Wirbelsäulenscores

Abstract

The aim of the study was the development and validation of a new subjective rating scale for assessment of outcome in patients with thoracolumbar fractures and fracture dislocations. The VAS spine score consists of 19 score items, using 100-mm visual analogue scales. The items are answered by the patients independently of rater assessment. To measure the analogue scales and calculate the score, a computer-aided system was evolved consisting of self-developed software and digitizer board. The overall score is the mean of all items answered with values between 0 and 100. The individual score loss is calculated as the difference between the preinjury score and at follow-up with values between 0 and 100. The VAS spine score was tested for reliability with a group of 136 healthy volunteers. We performed a test-retest study with an interval of 24 h. For statistical analysis of the validity, we prospectively followed a group of 53 patients with the new outcome score. We chose patients with injuries of the thoracolumbar spine, all having been operatively treated by combined posterior-anterior stabilization and fusion between 1994 and 1996. In the reference group, the average test score was 91.95 (58-100) and 92.10 (58-100) at retest. The mean individual difference between test and retest scored 1.037 (0-8). A high reliability was proved by a strong correlation with a coefficient of 0.976 (p < 0.001). A high internal consistency of the VAS spine score was shown by a Cronbach-alpha of 0.9117. The mean score for the preinjury status of the patients was comparable to the reference group, amounting to 89.60 (21-100). The mean score at the time of implant removal was significantly (p < 0.001) decreased to 58.25 (13-97). Until the time of follow-up a significant (p < 0.001) increase was noted, and the group scored 66.08 (15-100) at follow-up. This was a significant (p < 0.001) difference compared with the preinjury status. The individual score loss averaged 24.1 (0-80). In the patient group we also noted a Cronbach-alpha > 0.95, indicating a high internal consistency. With the VAS spine score the authors have inaugurated a new tool for outcome measurement in the treatment of patients with thoracolumbar injuries. The study has proved the score to be both reliable and valid. The application of the score is helpful in analyzing the subjective outcome, and the results can be correlated with objective measures. The score is a useful tool for comparative clinical studies, addressing the outcome after different methods of treatment.

Anterior vertebral body replacement with a titanium implant of adjustable height: a prospective clinical study

“…In the present study the reduction in VAS score was 21.1 which accounts for 1/5 of attainable score value. This value is just little lower than the score reduction of 24.1 reported by Knop et al [34] for patients treated with an internal fixator and bone chips. The score reduction obtained is similar to those found by previous [10,17,38] studies using other questionnaires.…”

“…• Radiological results: pre-and post-operative measurement of conventional X-ray pictures, course over In addition to the collection of these objective data, the patient's subjective state and back function in daily life were also ascertained using a visual analogue scale (VAS) [34]. The scale contains 19 questions on back pain and functional limitation of the spine or back.…”

“…This value can be between 0 and 100. The questionnaire is specific to the spine and has been validated [34,35]. Since a certain level of understanding of the language is required to answer the questions, the VAS questionnaire was completed only by patients who had adequate knowledge of German.…”

Minimally Invasive Sacroiliac Joint Arthrodesis: Experience in a Prospective Series with 24 Patients

“…The VAS is a known and validated [22] measurement instrument from one (no pain) to ten (worst pain ever) that results easy and fast to be applied. The ODI is an index that is derived from the Oswestry Low Back Pain Questionnaire used by clinicians and researchers to quantify disability for low back pain [23].…”

Operative treatment of 733 patients with acute thoracolumbar spinal injuries: comprehensive results from the second, prospective, internet-based multicenter study of the Spine Study Group of the German Association of Trauma Surgery

“…The VAS spine score (0-100 points) is a self-reporting tool to measure subjective back functioning [44]. Table 6 shows the summary of the VAS spine score results and score loss throughout the course of treatment and level of injury.…”