Cross-cultural adaptation and validation of the simplified Chinese version of the Fukushima Lumbar Spinal Stenosis Scale

Eur Spine J. 2024 Nov 22. doi: 10.1007/s00586-024-08562-6. Online ahead of print.

Abstract

Purpose: To translate and cross-culturally adapt Fukushima Lumbar Spinal Stenosis Scale into a Simplified Chinese version (FLS-25-SC), and evaluate the reliability and validity of FLS-25-SC in patients with lumbar spinal stenosis.

Methods: Test-retest reliability was assessed by Intra-class correlation coefficient (ICC). Construct validity was analyzed by correlations between FLS-25-SC and the Swiss Spinal Stenosis (SSS) Questionnaire, Visual analogue scale (VAS) as well as the short form (36) health survey (SF-36).

Results: The original version of the FLS-25 was cross-culturally adapted and translated into Simplified Chinese. FLS-25-SC was indicated to have excellent reliability (Cronbach's alpha = 0.941, ICC = 0.952). FLS-25-SC had almost perfect correlation with Physical Functioning (r = -0.870, P < 0.001) subscale of SF-36. Moderate to substantial correlations between FLS-25-SC and Symptom severity (r = 0.542, P < 0.001), Physical function (r = 0.604, P < 0.001) subscales of Swiss Spinal Stenosis (SSS) Questionnaire, VAS (r = 0.613, P < 0.001), as well as Role Physical (r = -0.537, P < 0.001) and Bodily Pain (r = -0.474, P < 0.001). It was observed that the loading of the 3 factors explained 63.108% of the total variance: [Kaiser-Mayer-Olkin (KMO) = 0.903, C2 = 1769.491, p < 0.001].

Conclusion: FLS-25-SC has been shown to have acceptable reliability and validity in patients with degenerative lumbar spinal stenosis and may be recommended for patients in Chinese mainland.

Keywords: Cross-cultural adaptation; Fukushima lumbar spinal stenosis scale; Lumbar spinal stenosis; Reliability; Simplified Chinese; Validity.