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Disease-specific measures of the impact of sacroiliac (SI) joint pain on back/pelvis function are not available. The Oswestry Disability Index (ODI) is a validated functional measure for lower back pain, but its responsiveness to SI joint treatment has yet to be established. We sought to assess the validity of ODI to capture disability caused by SI joint pain and the minimum clinically important difference (MCID) after SI joint treatment.
Patients (n = 155) participating in a prospective clinical trial of minimally invasive SI joint fusion underwent baseline and follow-up assessments using ODI, visual analog scale (VAS) pain assessment, Short Form 36 (SF-36), EuroQoL-5D, and questions (at follow-up only) regarding satisfaction with the SI joint fusion and whether the patient would have the fusion surgery again. All outcomes were compared from baseline to 12 months postsurgery. The health transition item of the SF-36 and the satisfaction scale were used as external anchors to calculate MCID. MCID was estimated for ODI using four calculation methods: (1) minimum detectable change, (2) average ODI change of patients’ subsets, (3) change difference between patients’ subsets, and (4) receiver operating characteristic (ROC) curve.
After SI fusion, patients improved significantly (p < .0001) on all measures: SI joint pain (48.8 points), ODI (23.8 points), EQ-5D (0.29 points), EQ-5D VAS (11.7 points), PCS (8.9 points), and MCS (9.2 points). The improvement in ODI was significantly correlated (p < .0001) with SI joint pain improvement (r = .48) and with the two external anchors: SF-36 health transition item (r = .49) and satisfaction level (r = .34). The MCID values calculated for ODI using the various methods ranged from 3.5 to 19.5 points. The ODI minimum detectable change was 15.5 with the health transition item as the anchor and 13.5 with the satisfaction scale as the anchor.
ODI is a valid measure of change in SI joint health. Hence, researchers and clinicians may rely on ODI scores to measure disability caused by SI pain. We estimated the MCID for ODI to be 13–15 points, which falls within the range of that previously reported for lumbar back pain and indicates that an improvement in disability should be at least 15 % to be beyond random variation.
Murray, C. J., Vos, T., Lozano, R., Naghavi, M., Flaxman, A. D., Michaud, C., et al. (2012). Disability-adjusted life years (DALYs) for 291 diseases and injuries in 21 regions, 1990–2010: A systematic analysis for the Global Burden of Disease Study 2010. The Lancet,380(9859), 2197–2223. doi: 10.1016/S0140-6736(12)61689-4. CrossRef
Salomon, J. A., Vos, T., Hogan, D. R., Gagnon, M., Naghavi, M., Mokdad, A., et al. (2012). Common values in assessing health outcomes from disease and injury: Disability weights measurement study for the Global Burden of Disease Study 2010. The Lancet,380(9859), 2129–2143. doi: 10.1016/S0140-6736(12)61680-8. CrossRef
Sembrano, J. N., & Polly, D. W., Jr. (2009). How often is low back pain not coming from the back? Spine ( Phila Pa 1976), 34(1), E27–E32, doi: 10.1097/BRS.0b013e31818b8882.
Bernard, T. N., Jr., & Kirkaldy-Willis, W. H. (1987). Recognizing specific characteristics of nonspecific low back pain. Clinical Orthopaedics and Related Research, 217, 266–280.
Goldthwait, J. E., & Osgood, R. B. (1905). A consideration of the pelvic articulations from an anatomical, pathological and clinical standpoint. The Boston Medical and Surgical Journal,152, 593–601. CrossRef
Forst, S. L., Wheeler, M. T., Fortin, J. D., & Vilensky, J. A. (2006). The sacroiliac joint: Anatomy, physiology and clinical significance. Pain Physician,9(1), 61–67. PubMed
Fortin, J. D., Dwyer, A. P., West, S., & Pier, J. (1994). Sacroiliac joint: Pain referral maps upon applying a new injection/arthrography technique. Part I: Asymptomatic volunteers. Spine ( Phila Pa 1976) , 19(13), 1475–1482.
Fortin, J. D., Washington, W. J., & Falco, F. J. (1999). Three pathways between the sacroiliac joint and neural structures. AJNR, American Journal of Neuroradiology,20(8), 1429–1434. PubMed
Fortin, J. D., & Tolchin, R. B. (2003). Sacroiliac arthrograms and post-arthrography computerized tomography. Pain Physician,6(3), 287–290. PubMed
Manchikanti, L., Abdi, S., Atluri, S., Benyamin, R. M., Boswell, M. V., Buenaventura, R. M., et al. (2013). An update of comprehensive evidence-based guidelines for interventional techniques in chronic spinal pain. Part II: Guidance and recommendations. Pain Physician,16(2 Suppl), S49–S283. PubMed
Pauza, K. (2008). Educational Guidelines for Interventional Spinal Procedures. https://www.aapmr.org/practice/guidelines/Documents/edguidelines.pdf. Accessed June 5 2015.
International Spine Intervention Society. (2004). Practice guidelines for spinal diagnostic and treatment procedures. San Rafael, CA: International Spine Intervention Society.
Manchikanti, L., Boswell, M. V., Singh, V., Benyamin, R. M., Fellows, B., Abdi, S., et al. (2009). Comprehensive evidence-based guidelines for interventional techniques in the management of chronic spinal pain. Pain Physician,12(4), 699–802. PubMed
American Society of Anesthesiologists Task Force on Chronic Pain Management, & American Society of Regional Anesthesia and Pain Medicine. (2010). Practice guidelines for chronic pain management: An updated report by the American Society of Anesthesiologists Task Force on Chronic Pain Management and the American Society of Regional Anesthesia and Pain Medicine. Anesthesiology,112, 810–833. CrossRef
Jackson, R., & Porter, K. (2006). The pelvis and sacroiliac joint: Physical therapy patient management utilizing current evidence. In Current concepts of orthopaedic physical therapy. La Crosse, WI: American Physical Therapy Association.
Luukkainen, R. K., Wennerstrand, P. V., Kautiainen, H. H., Sanila, M. T., & Asikainen, E. L. (2002). Efficacy of periarticular corticosteroid treatment of the sacroiliac joint in non-spondylarthropathic patients with chronic low back pain in the region of the sacroiliac joint. Clinical and Experimental Rheumatology,20(1), 52–54. PubMed
Luukkainen, R., Nissila, M., Asikainen, E., Sanila, M., Lehtinen, K., Alanaatu, A., et al. (1999). Periarticular corticosteroid treatment of the sacroiliac joint in patients with seronegative spondylarthropathy. Clinical and Experimental Rheumatology,17(1), 88–90. PubMed
Cohen, S. P., Hurley, R. W., Buckenmaier, C. C, I. I. I., Kurihara, C., Morlando, B., & Dragovich, A. (2008). Randomized placebo-controlled study evaluating lateral branch radiofrequency denervation for sacroiliac joint pain. Anesthesiology,109(2), 279–288. doi: 10.1097/ALN.0b013e31817f4c7c. PubMedCentralCrossRefPubMed
Buchowski, J. M., Kebaish, K. M., Sinkov, V., Cohen, D. B., Sieber, A. N., & Kostuik, J. P. (2005). Functional and radiographic outcome of sacroiliac arthrodesis for the disorders of the sacroiliac joint. The Spine Journal, 5(5), 520–528; discussion 529. doi: 10.1016/j.spinee.2005.02.022.
Gaetani, P., Miotti, D., Risso, A., Bettaglio, R., Bongetta, D., Custodi, V., et al. (2013). Percutaneous arthrodesis of sacro-iliac joint: A pilot study. Journal of Neurosurgical Sciences,57(4), 297–301. PubMed
Duhon, B. S., Cher, D. J., Wine, K. D., Lockstadt, H., Kovalsky, D., & Soo, C. L. (2013). Safety and 6-month effectiveness of minimally invasive sacroiliac joint fusion: A prospective study. Medical Devices (Auckl),6, 219–229. doi: 10.2147/MDER.S55197.
Fairbank, J., Couper, J., & Davies, J. (1980). The Oswestry low back pain disability questionnaire. Physiotherapy,66, 271–273. PubMed
Baker, D. J., Pynsent, P. B., & Fairbank, J. C. T. (1989). The Oswestry Disability Index revisited: Its reliability, repeatability, and validity, and a comparison with the St. Thomas’s Disability Index. In Roland, M. O., & Jenner, J. R. (Eds.), Back pain: New approaches to rehabilitation and education (pp. 174–186). Manchester, England: Manchester University Press.
Copay, A. G., Glassman, S. D., Subach, B. R., Berven, S., Schuler, T. C., & Carreon, L. (2008). The minimum clinically important difference in lumbar spine surgery patients. A choice of methods using the Oswestry Disability Index, MOS Short Form 36, and Pain Scales. The Spine Journal,8(6), 968–974. CrossRefPubMed
Parker, S. L., Adogwa, O., Paul, A. R., Anderson, W. N., Aaronson, O., Cheng, J. S., et al. (2011). Utility of minimum clinically important difference in assessing pain, disability, and health state after transforaminal lumbar interbody fusion for degenerative lumbar spondylolisthesis. Journal of Neurosurgery: Spine,14(5), 598–604. PubMed
Parker, S. L., Mendenhall, S. K., Shau, D., Adogwa, O., Cheng, J. S., Anderson, W. N., et al. (2012). Determination of minimum clinically important difference in pain, disability, and quality of life after extension of fusion for adjacent-segment disease. Journal of Neurosurgery: Spine,16(1), 61–67. PubMed
Parker, S. L., Mendenhall, S. K., Shau, D. N., Adogwa, O., Anderson, W. N., Devin, C. J., et al. (2012). Minimum clinically important difference in pain, disability, and quality of life after neural decompression and fusion for same-level recurrent lumbar stenosis: Understanding clinical versus statistical significance. Journal of Neurosurgery: Spine,16(5), 471–478. PubMed
Fortin, J. D., & Falco, F. J. (1997). The Fortin finger test: An indicator of sacroiliac pain. American Journal of Orthopedics (Belle Mead NJ),26(7), 477–480.
Ha, K. Y., Lee, J. S., & Kim, K. W. (2008). Degeneration of sacroiliac joint after instrumented lumbar or lumbosacral fusion: A prospective cohort study over five-year follow-up. Spine (Phila Pa 1976), 33(11), 1192–1198. doi: 10.1097/BRS.0b013e318170fd35.
Whang, P. G., Cher, D. J., Polly, D. W., et al. (2015). Sacroiliac joint fusion using triangular titanium implants vs. non-surgical management: Six-month outcomes from a prospective randomized controlled trial. International Journal of Spine Surgery, 9(6). doi: 10.14444/2006.
EuroQol, G. (1990). EuroQol—a new facility for the measurement of health-related quality of life. Health Policy,16(3), 199–208. CrossRef
Hägg, O., Fritzell, P., & Nordwall, A. (2003). The clinical importance of changes in outcome scores after treatment for chronic low back pain. European Spine Journal,12, 12–20. PubMed
U.S. Department of Health and Human Services, Food and Drug Administration, & Center for Devices and Radiological Health. (2000). Guidance document for the preparation of IDEs for spinal systems. Rockville, MD: U.S. Department of Health and Human Services.
Junge, A., Dvorak, J., & Ahrens, S. (1995). Predictors of bad and good outcomes of lumbar disc surgery. A prospective clinical study with recommendations for screening to avoid bad outcomes. Spine ( Phila Pa 1976), 20(4), 460–468.
Hagg, O., Fritzell, P., Ekselius, L., & Nordwall, A. (2003). Predictors of outcome in fusion surgery for Chronic Low Back Pain. A report from the Swedish Lumbar Spine Study Group. European Spine Journal,12, 22–33. PubMed
Hellum, C., Johnsen, L. G., Gjertsen, O., Berg, L., Neckelmann, G., Grundnes, O., et al. (2012). Predictors of outcome after surgery with disc prosthesis and rehabilitation in patients with chronic low back pain and degenerative disc: 2-year follow-up. European Spine Journal,21(4), 681–690. doi: 10.1007/s00586-011-2145-3. PubMedCentralCrossRefPubMed
Adogwa, O., Parker, S. L., Shau, D. N., Mendenhall, S. K., Bydon, A., Cheng, J. S., et al. (2013). Preoperative Zung depression scale predicts patient satisfaction independent of the extent of improvement after revision lumbar surgery. The Spine Journal,13(5), 501–506. doi: 10.1016/j.spinee.2013.01.017. CrossRefPubMed
Mannion, A. F., Fekete, T. F., Porchet, F., Haschtmann, D., Jeszenszky, D., & Kleinstuck, F. S. (2014). The influence of comorbidity on the risks and benefits of spine surgery for degenerative lumbar disorders. European Spine Journal,23(Suppl 1), S66–S71. doi: 10.1007/s00586-014-3189-y. CrossRefPubMed
Urban-Baeza, A., Zarate-Kalfopulos, B., Romero-Vargas, S., Obil-Chavarria, C., Brenes-Rojas, L., & Reyes-Sanchez, A. (2015). Influence of depression symptoms on patient expectations and clinical outcomes in the surgical management of spinal stenosis. Journal of Neurosurgery: Spine,22(1), 75–79. doi: 10.3171/2014.10.SPINE131106. PubMed
Lubelski, D., Thompson, N. R., Bansal, S., Mroz, T. E., Mazanec, D. J., Benzel, E. C., et al. (2015). Depression as a predictor of worse quality of life outcomes following nonoperative treatment for lumbar stenosis. J Neurosurg Spine,22(3), 267–272. doi: 10.3171/2014.10.SPINE14220. CrossRefPubMed
- Is the Oswestry Disability Index a valid measure of response to sacroiliac joint treatment?
Anne G. Copay
Daniel J. Cher
- Springer International Publishing