Patient-Reported Outcomes in Spinal Surgery

Patient-reported outcomes (PROs) have become central to the evaluation of spinal surgery, reflecting the patient’s perspective on pain, function and quality of life following operative intervention. Standardised patient-reported outcome measures (PROMs) such as the Oswestry Disability Index (ODI), Visual Analogue Scale (VAS) and 36-Item Short Form Health Survey (SF-36) enable systematic quantification of pain intensity, functional disability and broader health status. Beyond traditional questionnaires, emerging approaches include natural language processing of patient narratives and registry-based surveillance that capture outcomes at population scale. The integration of PROs into clinical decision-making supports personalised care pathways, informs surgical technique development and underpins health-economic assessments. International registries have demonstrated the feasibility of long-term follow-up, while methodological research on minimal clinically important differences (MCID) and global assessment scales has refined the interpretation of meaningful change. Together, these advances elevate patient-centred metrics to a co-primary endpoint, complementing radiological and surgical success criteria.

Research from Nature Portfolio

A 2023 study of 113 patients undergoing lumbar microdiscectomy evaluated radiological severity of disc degeneration alongside serial assessments of pain and life satisfaction over 12 months. Preoperative grading by magnetic resonance imaging was correlated with Visual Analogue Scale scores, Oswestry Disability Index values and Satisfaction with Life Scale results. Pain intensity declined significantly from baseline to one year, while life satisfaction scores rose in parallel. Statistical analysis demonstrated that both pain and disability improvements were closely linked to the initial degree of degenerative change. This work underscores the capacity of standardised PROMs to mirror anatomical findings and to quantify postoperative recovery in spinal surgery cohorts.

Patient-Reported Outcomes in Spinal Surgery publication trend

The graph below shows the total number of articles in patient-reported outcomes in spinal surgery across all publications each year (not limited to Nature Index journals).

Technical terms

Oswestry Disability Index (ODI): A questionnaire measuring functional disability due to low back pain, scored from 0 (no disability) to 100 (maximum disability).
Visual Analogue Scale (VAS): A continuous scale, usually 0–10 cm, on which patients indicate intensity of pain.
36-Item Short Form Health Survey (SF-36): A generic measure of health status covering physical functioning, pain, vitality and mental health.
Minimum Clinically Important Difference (MCID): The smallest change in a PROM score that patients perceive as beneficial.
Natural Language Processing (NLP): Computational techniques for analysing and deriving quantitative data from free-text patient narratives.
Global Perceived Effect (GPE) Scale: A single-item measure by which patients rate overall change in health status compared to baseline.

References

1. Assessment of quality of life, pain level and disability outcomes after lumbar discectomy. Scientific Reports (2023).
2. National spine surgery registries’ characteristics and aims: globally accepted standards have yet to be met. Results of a scoping review and a complementary survey. Journal of Orthopaedics and Traumatology (2023).
3. Follow-up score, change score or percentage change score for determining clinical important outcome following surgery? An observational study from the Norwegian registry for Spine surgery evaluating patient reported outcome measures in lumbar spinal stenosis and lumbar degenerative spondylolisthesis. BMC Musculoskeletal Disorders (2019).
4. A Spine-Specific Lexicon for the Sentiment Analysis of Interviews with Adult Spinal Deformity Patients Correlates with SF-36, SRS-22, and ODI Scores: A Pilot Study of 25 Patients. Information (2025).
5. Responsiveness and minimal clinically important difference for pain and disability instruments in low back pain patients. BMC Musculoskeletal Disorders (2006).
6. The value of patient global assessment in lumbar spine surgery: an evaluation based on more than 90,000 patients. European Spine Journal (2017).