Pain Sensitivity and Pain Catastrophizing Are Associated With Persistent Pain and Disability After Lumbar Spine Surgery

被引:84
作者
Coronado, Rogelio A. [1 ]
George, Steven Z. [2 ,3 ]
Devin, Clinton J. [1 ]
Wegener, Stephen T. [4 ]
Archer, Kristin R. [1 ,5 ]
机构
[1] Vanderbilt Univ, Dept Orthopaed Surg, Nashville, TN 37235 USA
[2] Univ Florida, Dept Phys Therapy, Gainesville, FL USA
[3] Univ Florida, Pain Res & Intervent Ctr Excellence, Gainesville, FL USA
[4] Johns Hopkins Univ, Dept Phys Med & Rehabil, Baltimore, MD USA
[5] Vanderbilt Univ, Dept Phys Med & Rehabil, Nashville, TN 37235 USA
来源
ARCHIVES OF PHYSICAL MEDICINE AND REHABILITATION | 2015年 / 96卷 / 10期
基金
美国国家卫生研究院;
关键词
Catastrophization; Low back pain; Lumbar stenosis; Pain threshold; Prognosis; Rehabilitation; POSTOPERATIVE PAIN; KNEE REPLACEMENT; POSTSURGICAL PAIN; CLINICAL PAIN; BACK; PREDICTION; STENOSIS; FUSION; SENSITIZATION; MANAGEMENT;
D O I
10.1016/j.apmr.2015.06.003
中图分类号
R49 [康复医学];
学科分类号
100215 ;
摘要
Objective: To examine whether pain sensitivity and pain catastrophizing are associated with persistent pain and disability after lumbar spine surgery. Design: Prospective observational cohort study. Setting: Academic medical center. Participants: Patients (N=68; mean age, 57.9 +/- 13.1y; 40 women [58.8%]) undergoing spine surgery for a degenerative condition from March 1, 2012 to April 30, 2013 were assessed 6 weeks, 3 months, and 6 months after surgery. Interventions: Not applicable. Main Outcome Measures: The main outcome measures were persistent back pain intensity, pain interference, and disability. Patients with persistent back pain intensity, pain interference, or disability were identified as those patients reporting Brief Pain Inventory scores >= 4 and Oswestry Disability Index scores >= 21 at all postoperative time points. Results: From 6 weeks to 6 months after surgery, approximately 12.9%, 24.2%, and 46.8% of patients reported persistent back pain intensity, pain interference, or disability, respectively. Increased pain sensitivity at 6 weeks was associated with having persistent back pain intensity (odds ratio [OR], 2.0; 95% confidence interval [CI], 1.0-4.1) after surgery. Increased pain catastrophizing at 6 weeks was associated with having persistent back pain intensity (OR, 1.1; 95% CI, 1.0-1.2), pain interference (OR, 1.1; 95% CI, 1.0-1.2), and disability (OR, 1.3; 95% CI, 1.1-1.4). An interaction effect was not found between pain sensitivity and pain catastrophizing on persistent outcomes (P>.05). Conclusions: The findings suggest the importance of early postoperative screening for pain sensitivity and pain catastrophizing to identify patients at risk for poor postoperative pain intensity, pain interference, and/or disability outcomes. Future research should consider the benefit of targeted therapeutic strategies for patients with these postoperative prognostic factors. (C) 2015 by the American Congress of Rehabilitation Medicine
引用
收藏
页码:1763 / 1770
页数:8
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