Psychometric properties of the Cervical Spine Outcomes Questionnaire and its relationship to standard assessment tools used in spine research

Spine J. Mar-Apr 2007;7(2):174-9. doi: 10.1016/j.spinee.2006.07.005. Epub 2006 Dec 27.


Background: The Cervical Spine Outcomes Questionnaire (CSOQ), a disease-specific outcomes instrument, has not been systematically compared with the Short Form-36 (SF-36) or the Neck Disability Index (NDI).

Purpose: To examine the psychometric properties of the CSOQ and to compare them with those of the SF-36 and NDI.

Study design: Prospective analysis of outcomes data in patients undergoing surgery.

Methods: We used telephone surveys (CSOQ) and clinical assessments (SF-36 and NDI) to evaluate 534 patients undergoing anterior cervical decompression and fusion at 23 nationwide sites. The psychometric properties of the CSOQ were analyzed for floor/ceiling effect, internal consistency of items within the CSOQ, and concurrent validity with the SF-36 and NDI.

Results: The CSOQ domain scores showed good psychometric properties (Cronbach's alpha >0.70). Only physical symptoms (other than pain) showed a ceiling effect. The CSOQ domain scores had good concurrent validity (Spearman rank correlation coefficient >0.70) with the mental health score of the SF-36 and the total disability score of NDI.

Conclusions: The CSOQ domain scores provide a disease-specific assessment of functional limitations resulting from cervical spine disorders. The domain scores for functional disability and psychological distress provide similar information to that provided by the NDI and SF-36. The CSOQ domain scores for pain severity provide information that is more specific to cervical disc disease than does the physical health score of the SF-36.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't
  • Validation Study

MeSH terms

  • Cervical Vertebrae / surgery*
  • Decompression, Surgical
  • Disability Evaluation*
  • Humans
  • Pain / epidemiology
  • Pain / etiology
  • Pain / psychology
  • Psychometrics / methods*
  • Reproducibility of Results
  • Retrospective Studies
  • Severity of Illness Index*
  • Spinal Diseases / complications
  • Spinal Diseases / psychology
  • Spinal Diseases / surgery
  • Spinal Fusion
  • Surveys and Questionnaires