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慢性腰神经根性疼痛患者中的神经性疼痛成分。

The neuropathic pain component among patients with chronic low back-radicular pain.

作者信息

Sivas Filiz, Uzun Özlem, Başkan Bedriye, Bodur Hatice

出版信息

J Back Musculoskelet Rehabil. 2018;31(5):939-946. doi: 10.3233/BMR-160786.

Abstract

OBJECTIVES

Determining neuropathic pain component (NPC) among patients with chronic low back pain-radicular pain (CLBP-RP) and the adjustment between scales of neuropathic pain.

MATERIAL-METHODS: One hundred and one patients with CLBP-RP were included in the study. The severity of CLBP-RP was evaluated by visual analogue scale (VAS). The Douleur Neuropathique 4 Questions (DN4) and Leeds Assessment of Neuropathic Symptoms and Signs Scales (LANSS) were used to evaluate the NPC.

RESULTS

The mean score of CLBP-RP assessed by VAS was 80 mm. NPC was detected a rate of 65.3% by DN4 and 40.6% by LANSS. NPC was 75.4% in females and 47.2% in males according to DN4, and 52.3% in females and 19.4% in males according to LANSS. The female gender, occupation, and VAS scores were determined to be significant factors contributing to presence of NPC according to logistic regression analyses (p< 0.01, p< 0.05, p< 0.05). A medium degree accordance was established between DN4 and LANSS scales according to kappa coefficient (Kappa = 0.532, p< 0.05).

CONCLUSION

CLBP is among the diseases causing mixed type pain accompanied by nociceptive and neuropathic pain. NPC was detected in a considerable part of patients with radicular pain. Identifying the character of radicular pain is significant to develop proper management strategies.

摘要

目的

确定慢性下腰痛伴神经根性疼痛(CLBP-RP)患者的神经性疼痛成分(NPC)以及神经性疼痛量表之间的校准情况。

材料与方法

本研究纳入了101例CLBP-RP患者。采用视觉模拟量表(VAS)评估CLBP-RP的严重程度。使用神经病理性疼痛4项问卷(DN4)和利兹神经病理性症状和体征评估量表(LANSS)评估NPC。

结果

VAS评估的CLBP-RP平均评分为80mm。DN4检测到NPC的比例为65.3%,LANSS为40.6%。根据DN4,女性NPC为75.4%,男性为47.2%;根据LANSS,女性为52.3%,男性为19.4%。根据逻辑回归分析,女性、职业和VAS评分被确定为导致NPC存在的显著因素(p<0.01,p<0.05,p<0.05)。根据kappa系数,DN4和LANSS量表之间建立了中等程度的一致性(Kappa = 0.532,p<0.05)。

结论

CLBP是导致伴有伤害性疼痛和神经性疼痛的混合型疼痛的疾病之一。在相当一部分神经根性疼痛患者中检测到了NPC。确定神经根性疼痛的特征对于制定适当的管理策略具有重要意义。

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