SPINE Volume 25, Number 22, pp 2940 –2953 ©2000, Lippincott Williams & Wilkins, Inc.

The Oswestry Disability Index
Jeremy C. T. Fairbank, MD, FRCS,* and Paul B. Pynsent, PhD† tried. The questionnaire had been published in 198038 and widely disseminated from the 1981 meeting of the International Society for the Study of the Lumbar Spine (ISSLS) in Paris. The objects of this article are: To present the various versions of the ODI instrument for comparison ● To review the various efforts that have been made to validate this questionnaire ● To compare the scores obtained in studies of different patient population both before and after treatment ● To review the methodology of outcome measurement ● To consider what is actually measured by this and similar instruments
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Study Design. The Oswestry Disability Index (ODI) has become one of the principal condition-specific outcome measures used in the management of spinal disorders. This review is based on publications using the ODI identified from the authors’ personal databases, the Science Citation Index, and hand searches of Spine and current textbooks of spinal disorders. Objectives. To review the versions of this instrument, document methods by which it has been validated, collate data from scores found in normal and back pain populations, provide curves for power calculations in studies using the ODI, and maintain the ODI as a gold standard outcome measure. Summary of Background Data. It has now been 20 years since its original publication. More than 200 citations exist in the Science Citation Index. The authors have a large correspondence file relating to the ODI, that is cited in most of the large textbooks related to spinal disorders. Methods. All the published versions of the questionnaire were identified. A systematic review of this literature was made. The various reports of validation were collated and