Global Spine J 2016; 06(08): 804-811
DOI: 10.1055/s-0036-1579745
Review Article
Georg Thieme Verlag KG Stuttgart · New York

Outcome Instruments in Spinal Trauma Surgery: A Bibliometric Analysis

Holt S. Cutler1, Javier Z. Guzman1, James Connolly1, Motasem Al Maaieh1, Branko Skovrlj2, Samuel K. Cho1
  • 1Department of Orthopaedic Surgery, Icahn School of Medicine at Mount Sinai, New York, New York, United States
  • 2Department of Neurosurgery, Icahn School of Medicine at Mount Sinai, New York, New York, United States
Further Information

Publication History

13 October 2015

20 January 2016

Publication Date:
07 March 2016 (eFirst)


Study Design Literature review.

Objective To identify outcomes instruments used in spinal trauma surgery over the past decade, their frequency of use, and usage trends.

Methods Five top orthopedic journals were reviewed from 2004 to 2013 for clinical studies of surgical intervention in spinal trauma that reported patient-reported outcome instruments use or neurologic function scale use. Publication year, level of evidence (LOE), and outcome instruments were collected for each article and analyzed.

Results A total of 58 studies were identified. Among them, 26 named outcome instruments and 7 improvised questionnaires were utilized. The visual analog scale (VAS) for pain was used most frequently (43.1%), followed by the Short Form 36 (34.5%), Frankel grade scale (25.9%), Oswestry Disability Index (20.7%) and American Spinal Injury Association Impairment Scale (15.5%). LOE 4 was most common (37.9%), and eight LOE 1 studies were identified (10.3%).

Conclusions The VAS pain scale is the most common outcome instrument used in spinal trauma. The scope of this outcome instrument is limited, and it may not be sufficient for discriminating between more and less effective treatments. A wide variety of functional measures are used, reflecting the need for a disease-specific instrument that accurately measures functional limitation in spinal trauma.