French-Canadian Adaptation and Validation of the Swiss Spinal Stenosis Questionnaire for Patients With Lumbar Spinal Stenosis.

STUDY DESIGN: An observational prospective study.

OBJECTIVE: The study objective was to assess the reliability and validity of the French-Canadian version (FCSSSQ) of the Swiss Spinal Stenosis questionnaire (SSSQ).

SUMMARY OF BACKGROUND DATA: The SSSQ is a validated disease-specific tool developed to assess pain, function, and satisfaction with care in patients with lumbar spinal stenosis (LSS).

METHODS: The French-Canadian translation and adaptation of the SSSQ was completed following a four-stage approach: (1) forward translation; (2) synthesis; (3) expert committee review; and (4) testing of the questionnaire prefinal version. Psychometric properties were subsequently determined in patients who had undergone decompressive surgery for degenerative LSS. Patients completed the SSSQ adapted version, the Numerical Rating Scale, and the Oswestry Disability Index. Test-retest reliability was assessed with weighted Kappa score and intraclass correlation coefficient. Construct validity was evaluated using the Spearman correlation coefficient and responsiveness with the mean standardized response as well as the area under the receiver operating characteristic curve (AUROC). Floor and ceiling effects and internal consistency were also evaluated.

RESULTS: Twenty-five and 50 patients were included for the adaptation and validation processes, respectively. The test-retest reliability of the FCSSSQ total score was excellent [intraclass correlation coefficient (ICC) = 0.996; 95% confidence interval (95% CI) 0.938-0.982]. High Spearman correlation coefficients were also found between the total FCSSSQ score and the leg pain Numerical Rating Scale (NRS, 0.801), back pain NRS (0.705), and the Oswestry Disability Index (ODI, 0.825) scores. External responsiveness analysis was satisfactory with an AUROC of 0.875 (95% CI 0.744-1.0). The lowest FCSSSQ possible score was observed in five patients (10%), whereas no patients reported the highest possible score. The Cronbach α coefficient ranged from 0.810 to 0.945 indicating good to excellent internal consistency.

CONCLUSION: The French-Canadian version of the SSSQ is a reliable and valid questionnaire consistent with the original English version. This new version will help French-speaking clinicians and scientists document changes in condition and treatment satisfaction in patients with LSS.

LEVEL OF EVIDENCE: 2.