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Calculator of Puerto-Vazquez et al for Referral of a Patient with Lumbar Degenerative Disease for Spinal Surgery Consultation

Description

Puerto-Vazquez et al reported a model for deciding if a patient with lumbar degenerative disease should be referred to a spinal surgeon. The authors are from Hospital Universitario Clinico San Carlos, Hospital General Nuestra Senora del Prado and Gerencia de AtencionIntegrada de Talavera de la Reina in Spain.


Parameters:

(1) age of the patient in years

(2) Waddell's non-organic signs

(3) sign of Lasegue (straight leg raising test)

(4) plain spinal X-rays

 

Parameter

Finding

Points

age in years

 

0.028 * (age)

Waddell signs

negative

0

 

positive

1.91

Lasegue sign

normal

0

 

abnormal

-1.59

spinal X-rays

normal

0

 

abnormal

-1.089

 

value of X =

= SUM(points for all of the parameters) - 1.966

 

probability of not having surgery =

= 1 / (1 + EXP((-1) * X))

 

probability of having surgery =

= 1 - (probability of not having surgery)

 

Interpretation:

• A patient with a need for surgery > 62% should be referred to a spine surgeon.

 

Performance:

• The score was found to have a reliability of 70%.


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