Ohnmeiss D D, Vanharanta H, Guyer R D
Texas Back Institute Research Foundation, Plano, USA.
Spine (Phila Pa 1976). 1995 Mar 15;20(6):729-33. doi: 10.1097/00007632-199503150-00015.
Pain drawings were scored and their relationship to discographic pain responses was investigated.
The purpose of this study was to determine if there was a relationship between patients indicating pain in nonanatomic patterns on pain drawings (possibly suggestive of a tendency to overreport pain) and discographic pain responses, and in particular, if patients with abnormal drawings were more likely to provide false-positive discographic pain reports.
Patients with abnormal pain drawings have been found to have elevated scores on the hysteria and hypochondriasis scales of the Minnesota Multiphasic Personality Inventory. Elevations on these same two scales have been related to discordant discographic pain reports.
Pain drawings were completed by 170 patients the day of, but before computed tomography/discography. The drawings were scored as described by Ransford et al and classified as normal or abnormal. The number of levels at which a patient reported pain and the incidence of false-positive computed tomographic/discographic pain reports were compared for the two pain drawing groups.
Patients with abnormal drawings reported pain at more levels than patients with normal ones. When dealing specifically with false-positive pain reports (pain reproduction on the injection of a nondisrupted disc), among the 105 patients in the normal group, only 13 (12.3%) reported false-positive pain. This was significantly less than the 50.0% (18 of 36) reporting false-positive pain in the abnormal group. The overall accuracy of pain drawings in differentiating patients with false-positive pain reports was 78.0% (110 of 141).
There is a relationship between pain drawings and discographic pain responses. Pain drawings can help identify patients who may be likely to report pain on injection of a nondisrupted disc. While it was not totally sensitive to this occurrence, it can help identify at least some of the patients in whom pain responses should be interpreted cautiously.
对疼痛绘图进行评分，并研究其与椎间盘造影疼痛反应的关系。
本研究的目的是确定在疼痛绘图上以非解剖模式表明疼痛的患者（可能提示有过度报告疼痛的倾向）与椎间盘造影疼痛反应之间是否存在关系，特别是异常绘图的患者是否更有可能提供假阳性的椎间盘造影疼痛报告。
已发现疼痛绘图异常的患者在明尼苏达多相人格调查表的癔症和疑病症量表上得分升高。这两个量表上的得分升高与不一致的椎间盘造影疼痛报告有关。
170名患者在计算机断层扫描/椎间盘造影当天但在其之前完成疼痛绘图。按照兰斯福德等人的描述对绘图进行评分，并分类为正常或异常。比较两个疼痛绘图组患者报告疼痛的节段数以及计算机断层扫描/椎间盘造影假阳性疼痛报告的发生率。
绘图异常的患者报告疼痛的节段比绘图正常的患者更多。在专门处理假阳性疼痛报告（注射未破裂椎间盘时出现疼痛再现）时，正常组的105名患者中，只有13名（12.3%）报告了假阳性疼痛。这显著低于异常组中报告假阳性疼痛的50.0%（36名中的18名）。疼痛绘图区分假阳性疼痛报告患者的总体准确率为78.0%（141名中的110名）。
疼痛绘图与椎间盘造影疼痛反应之间存在关系。疼痛绘图有助于识别可能在注射未破裂椎间盘时报告疼痛的患者。虽然它对此情况并非完全敏感，但它至少可以帮助识别出一些应对疼痛反应进行谨慎解读的患者。
