Why and how should we measure outcomes in spine surgery?

The objectives of spinal surgery for degenerative disorders are to reduce pain and disability and improve patients' quality of life while allowing an early return to work. The incongruence between surgeons' perspectives, findings of imaging exams in terms of fusion statuses or adequate decompression, and patients' satisfaction levels with treatment have underscored the need to evaluate outcomes of spinal surgery with a specific focus on patients' perspectives. Patient-reported outcomes (PRO) are reports on health status taken directly from patients without interference from physicians. In recent decades, several generic and disease-specific PRO instruments have been developed and validated in patients with spinal disorders. In this paper, we review the most commonly used PRO instruments in patients with spinal disorders, focussing on their characteristics, applicability and minimum clinically important differences.