• Matthew A Spiegel, Renaud Lafage, Virginie Lafage, Devon Ryan, Bryan Marascalchi, Yuriy Trimba, Christopher Ames, Bradley Harris, Elizabeth Tanzi, Jonathan Oren, Shaleen Vira, Thomas Errico, Frank Schwab, and Themistocles S Protopsaltis.
• *NYULMC Hospital for Joint Diseases, Department of Orthopaedic Surgery, Spine Division, New York City, NY †UCSF Medical Center, Department of Neurological Surgery, San Francisco, CA.
• Spine. 2016 Jan 1;41(1):74-81.

Study DesignRetrospective.ObjectiveThis study assessed the feasibility of combining Oswestry and Neck Disability Index (ODI and NDI) into 1 shorter "Total Disability Index" (TDI) from which reconstructed scores could be computed.Summary Of Background DataODI and NDI are not pure assessments of disability related to back and neck, respectively. Because of similarities/redundancies of questions, ODI scores may be elevated in neck-pain patients and the converse is true for NDI in back-pain patients.MethodsSpine patients completed ODI and NDI, and complaints were recorded as back pain (BP), neck pain (NP), or both (BNP). Questionnaire scores were compared across cohorts via descriptives and Spearman (ρ) correlations. In exploring the feasibility of merging ODI/NDI, TDI was constructed from 9 ODI and 5 NDI items. Extracting questions from TDI, reconstructed 9-item rODI and 10-item rNDI indices were formed and compared with true ODI/NDI.ResultsThere were a total of 1207 patients: 741 BP, 134 NP, and 268 BNP. Mean ODI was 37 ± 21 and mean NDI was 32 ± 21. Patients with concurrent BP and NP had significantly more disability. Seventy-eight patients of 134 (58%) patients with NP only had at least "moderate disability" by ODI and 297 of 741 (40%) patients with back pain only, had at least "moderate disability" by NDI. ODI versus NDI correlation was ρ = 0.755; ODI versus reconstructed rODI correlated at ρ = 0.985, and NDI versus reconstructed rNDI correlated at ρ = 0.967 (P < 0.01).ConclusionElevated ODI/NDI scores in patients with isolated complaints show that disability in 1 region affects scores on both surveys. This study constructed a 14-item TDI that represents every domain of ODI/NDI with exception of ODI "Sex Life." From this TDI, reconstructed scores correlated near perfectly with true scores. TDI provides a more global assessment of spinal disability and is a questionnaire that reduces the time burden to patients. The TDI allows for simultaneous assessment of back, neck, and global spinal disability.Level Of Evidence2.

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