Tachibana Toshiya, Maruo Keishi, Inoue Shinichi, Arizumi Fumihiro, Kusuyama Kazuki, Yoshiya Shinichi
Department of Orthopaedic Surgery, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya, Hyogo 663-8501 Japan.
Springerplus. 2016 Aug 9;5(1):1312. doi: 10.1186/s40064-016-2981-z. eCollection 2016.
The objectives of this study were to examine the diagnostic accuracy of pain drawing (PD) in determining the level of involvement and to investigate how the quantitative evaluation results of PD using a grid score (GS) correlates with the results of other clinical evaluation measures in diagnosis and assessment of patients with lumber disc herniation (LDH) involving a single nerve root. Thirty-one patients with single level LDH who were diagnosed and conservatively treated by the first author constituted the study population. In order to assess the diagnostic accuracy of PD, the level of involvement as determined by PD was compared to the final diagnosis. In 26 of the 31 patients who could be followed for more than 6 months of conservative treatment, the GS in PD evaluation was compared to the score assessed by the Japanese Orthopaedic Association scoring system for low back pain (JOA score) and the visual analog scale (VAS) both before and after the treatment. The overall diagnostic accuracy of PD for the determination of the affected level averaged 68.8 %, and the accuracy was higher at the L4/5 and L5/S levels than the L2/3 and L3/4 levels. The average values of VAS and GS significantly decreased and the JOA score significantly improved after the treatment. Moreover, a significant correlation was demonstrated between the scores derived from these three evaluation measures. The present study indicated the potential usefulness of PD in clinical assessment during the treatment course.
本研究的目的是检验疼痛图（PD）在确定受累程度方面的诊断准确性，并调查使用网格评分（GS）对PD进行定量评估的结果与其他临床评估指标在诊断和评估单神经根腰椎间盘突出症（LDH）患者时的结果之间的相关性。由第一作者诊断并进行保守治疗的31名单节段LDH患者构成了研究人群。为了评估PD的诊断准确性，将PD确定的受累程度与最终诊断结果进行比较。在31例接受超过6个月保守治疗且可随访的患者中，将26例患者PD评估中的GS与治疗前后由日本矫形外科学会腰痛评分系统（JOA评分）和视觉模拟量表（VAS）评估的分数进行比较。PD对确定受累节段的总体诊断准确性平均为68.8%，L4/5和L5/S节段的准确性高于L2/3和L3/4节段。治疗后VAS和GS的平均值显著降低，JOA评分显著改善。此外，这三种评估指标得出的分数之间存在显著相关性。本研究表明PD在治疗过程中的临床评估中具有潜在的有用性。
