Block A R, Vanharanta H, Ohnmeiss D D, Guyer R D
Texas Back Institute Research Foundation, Plano, USA.
Spine (Phila Pa 1976). 1996 Feb 1;21(3):334-8. doi: 10.1097/00007632-199602010-00017.
The possibility of a relationship between discographic pain responses and Minnesota Multiphasic Personality inventory scores was investigated.
To determine if patients with elevated Minnesota Multiphasic Personality Inventory scale scores were more likely to report pain on the injection of a nondisrupted disc than were patients without such high scores.
In general, injection into disrupted discs provokes pain, whereas injection into nondisrupted discs does not. However, discordant results are sometimes obtained and create a more difficult diagnostic challenge.
The primary study group was composed of 72 patients who underwent computed tomography/discography at the three lowest lumbar levels for diagnostic purposes and completed the Minnesota Multiphasic Personality Inventory.
The mean scores on the Minnesota Multiphasic Personality Inventory hypochondriasis and hysteria scales were significantly greater for patients reporting reproduction of clinical pain than for patients not reporting pain on injection of a nondisrupted disc (hypochondriasis: 77.2 vs. 68.6, P < 0.01; hysteria: 74.5 vs. 68.3, P < 0.05). The scores on the depression scale followed a similar trend (68.6 vs. 63.6, P < 0.15). Multivariate analysis, adjusting the means for possible confounding effects of age, symptom duration, and sex, did not alter the results.
Discographic pain reports are not only related to anatomic abnormalities, but are influenced by personality as assessed by the Minnesota Multiphasic Personality Inventory. Patients with elevated scores on the hypochondriasis, hysteria, and depression scales may tend to overreport pain during discographic injection. Among such patients, even those with a concordant computed tomography/discographic image, selection of therapeutic modalities should be made with caution.
调查了椎间盘造影疼痛反应与明尼苏达多相人格量表得分之间存在关联的可能性。
确定明尼苏达多相人格量表得分升高的患者比得分不高的患者在注射未破裂椎间盘时更有可能报告疼痛。
一般来说，向破裂的椎间盘内注射会引发疼痛，而向未破裂的椎间盘内注射则不会。然而，有时会得到不一致的结果，这带来了更具挑战性的诊断难题。
主要研究组由72例患者组成，这些患者因诊断目的接受了最低三个腰椎节段的计算机断层扫描/椎间盘造影，并完成了明尼苏达多相人格量表测试。
报告临床疼痛再现的患者在明尼苏达多相人格量表的疑病和癔症量表上的平均得分显著高于注射未破裂椎间盘时未报告疼痛的患者（疑病：77.2对68.6，P<0.01；癔症：74.5对68.3，P<0.05）。抑郁量表得分也呈现类似趋势（68.6对63.6，P<0.15）。在对年龄、症状持续时间和性别可能的混杂效应进行均值调整的多变量分析中，结果未改变。
椎间盘造影疼痛报告不仅与解剖异常有关，还受到明尼苏达多相人格量表评估的人格影响。疑病、癔症和抑郁量表得分升高的患者在椎间盘造影注射期间可能倾向于过度报告疼痛。在这类患者中，即使是那些计算机断层扫描/椎间盘造影图像一致的患者，在选择治疗方式时也应谨慎。
