The Impact of Spinal Problems on the Health Status of Patients: Have We Underestimated the Effect?

STUDY DESIGN.A prospective study of 17,774 patients who consulted spine centers in which the impact of spinal disorders and comorbidities on physical functional status were evaluated. OBJECTIVES.To quantify the effect spinal diagnoses have on patients’ physical functional status (SF-36 Physical Comp...

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Bibliographic Details
Published in:Spine (Philadelphia, PA. 1976) PA. 1976), 2000-06, Vol.25 (12), p.1509-1514
Main Authors: Fanuele, Jason C, Birkmeyer, Nancy J. O, Abdu, William A, Tosteson, Tor D, Weinstein, James N
Format: Article
Language:English
Subjects:
Activities of Daily Living
Adolescent
Adult
Aged
Aged, 80 and over
Back Pain - epidemiology
Back Pain - rehabilitation
Biological and medical sciences
Comorbidity
Diseases of the osteoarticular system
Diseases of the spine
Female
Health Status
Humans
Male
Medical sciences
Middle Aged
Prospective Studies
Spinal Diseases - epidemiology
Spinal Diseases - rehabilitation
United States - epidemiology
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Summary:STUDY DESIGN.A prospective study of 17,774 patients who consulted spine centers in which the impact of spinal disorders and comorbidities on physical functional status were evaluated. OBJECTIVES.To quantify the effect spinal diagnoses have on patients’ physical functional status (SF-36 Physical Component Summary [PCS] score) compared with other common conditions and to quantify the effects of comorbidities on physical functional status in spine patients. SUMMARY OF BACKGROUND DATA.The burden of spinal conditions on a patient’s function and the role that comorbidities play in this affliction are poorly quantified in the literature. METHODS.Data from the Health Survey Questionnaire were prospectively gathered through the National Spine Network, a nonprofit consortium of spine-focused practices. Each patient’s SF-36 score was summarized into a single PCS score. The correlation between diagnosis and comorbidity and PCS score was assessed using multivariate linear regression. RESULTS.The study patients were a mean of 47.5 years of age, 54.7% were female, 52.3% had lumbosacral diagnoses, and 82.0% had had 3 or more months of pain. The population had a mean PCS score of 30.4 ± 9.95 (SD) compared with 50.0 ± 10.00 for the general United States population. The more comorbidities in a patient, the lower the PCS score (Spearman rank correlation = −0.27). The five comorbid conditions that lowered the PCS the most included congestive heart failure (CHF), chronic obstructive pulmonary disease (COPD), renal failure, rheumatoid arthritis, and lupus (all P
ISSN:0362-2436
1528-1159
DOI:10.1097/00007632-200006150-00009