Outcome Measures in Spine Surgery: How Far Can we Go Building Evidence?

There is an imperative need to alleviate the actual and predictably harder burden of spine disorders and particularly the share due to chronic nonspecific low back pain, both at the individual and community - based viewpoint. Studies on global health trends charge a relevant part of the onus to the proposed invasive procedures, raising concern over its inappropriately high and growing use, counteracting clinical guidelines recommendation of a prudent selection of patients, based on clear - cut indications. Part of this gap between evidence and practice stands from questionable assumptions regarding the usefulness of surgery. Uncertainty on relative benefits and harms in the face of increased risk of adverse events, or the higher costs and health care resources i nvolved, results in controversial decision - making to plan the intervention . Improvement of knowledge about these questions can be provided by the inclusion in the research agenda of comprehensive and standardized evaluation of outcomes after spine surgery. Such a protocol procedure would enable future systematic reviews to perform a consistent meta - analysis of data from trials, mandatory for high - quality evidence gathering. Outcome evaluation requires both subjective and objective assessments. This review a ims to clarify the role of outcome measures in support of the need to build reliable information on the effectiveness of surgical treatment of spinal disorders.