Abstract

A form for accurate and reproducible record keeping was introduced into the orthopedic practice of one author at Rush--Presbyterian--St. Luke's Medical Center (RPSLMC) in 1976 and has been used in the evaluation of each new patient with a lumbar spine problem since that time. In order to demonstrate the usefulness and effectiveness of this form, a small subset of these patients (i.e., those with "spinal stenosis") who had had decompressive surgical treatment were recalled, reexamined, and the form redone completely. The format of the form then was changed (without changing the content) in order to give a numeric score to the various clinical subcategories covered in the history and physical examination. Within the parameters studied, significant changes were found in both of the major categories of pain and objective physical findings. This suggested that patients with "spinal stenosis" obtained definite, measurable benefit from surgical decompression during the period of 1-3 years following their surgery.

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