Comparison of Oswestry Disability Index Scores Between Surgical Candidates and General Population: Insights into Evaluation Criteria for Spine Surgery.

Abstract

A mixed-methods investigation with both retrospective and prospective components. Determine the mean Oswestry Disability Index (ODI) scores for individuals who underwent surgical intervention compared to a non-surgical population and identify threshold values that distinguish between these groups. The Oswestry Disability Index (ODI) quantifies disability in patients with low back pain and commonly serves as a significant determinant in lumbar spine pathology and surgical outcomes. An empirically established ODI threshold can aid in optimizing surgical decision-making processes. This study retrospectively analyzed 557 patients who consulted with a spine surgeon and subsequently underwent lumbar spine surgery from 2019 to 2023. Additionally, ODI scores were surveyed from 797 individuals in the general American population using the CloudResearch Connect platform, with participants matched for age and sex according to US census data. Mean ODI scores stratified by age group and sex were calculated for each cohort. Receiver Operating Characteristic (ROC) analysis was utilized to ascertain ODI cutoff values for different demographics. The retrospective cohort demonstrated a higher disability level with an overall mean ODI of 34.7 (95% CI [33.1, 36.2]) for ages 18-89. In contrast, the general population surveyed had a mean ODI of 14.4 (95% CI [13.3, 15.4]). An ROC-derived ODI threshold of 16.5 within the comprehensive age group of 18-89 exhibited a sensitivity of 0.84 and a specificity of 0.68. The ODI values identified in this study offer benchmarks that can assist in the evaluation process for spine surgery. These findings highlight the importance of considering ODI scores as part of a comprehensive clinical evaluation, rather than as standalone indicators for surgical intervention. Further prospective validation of these findings and their integration into clinical practice is recommended for future research.