Yonsei Med J.  2015 Jul;56(4):1044-1050. 10.3349/ymj.2015.56.4.1044.

Neuropathic Pain Components in Patients with Lumbar Spinal Stenosis

• Park SY
• An HS
• Moon SH
• Lee HM
• Suh SW
• Chen D
• Jeon JH

• KMID: 2366347
• DOI: http://doi.org/10.3349/ymj.2015.56.4.1044

Abstract

PURPOSE
To determine the prevalence and characteristics of neuropathic pain (NP) in patients with lumbar spinal stenosis (LSS) according to subgroup analysis of symptoms.
MATERIALS AND METHODS
We prospectively enrolled subjects with LSS (n=86) who were scheduled to undergo spinal surgery. The patients were divided into two groups according to a chief complaint of radicular pain or neurogenic claudication. We measured patient's pain score using the visual analog scale (VAS), Oswestry Disability Index (ODI) and Leads Assessment of Neuropathic Symptoms and Signs (LANSS). According to LANSS value, the prevalence of NP component pain in patients with LSS was assessed. Statistical analysis was performed to find the relationship between LANSS scores and the other scores.
RESULTS
From our sample of 86 patients, 31 (36.0%) had a NP component, with 24 (63.4%) in the radicular pain group having NP. However, only seven patients (15.6%) in the neurogenic claudication group had NP. The LANSS pain score was not significantly correlated with VAS scores for back pain, but did correlate with VAS scores for leg pain (R=0.73, p<0.001) and with ODI back pain scores (R=0.54, p<0.01).
CONCLUSION
One-third of the patients with LSS had a NP component. The presence of radicular pain correlated strongly with NP. The severity of leg pain and ODI score were also closely related to a NP component. This data may prove useful to understanding the pain characteristics of LSS and in better designing clinical trials for NP treatment in patients with LSS.

Keyword

Neuropathic pain; spinal stenosis; visual analog scale; Oswestry Disability Index; Leads Assessment of Neuropathic Symptoms and Signs

MeSH Terms

Adult
Aged
Back Pain
Decompression, Surgical
Disability Evaluation
Female
Humans
*Lumbar Vertebrae/surgery
Male
Middle Aged
Neuralgia/*complications/epidemiology
Outcome Assessment (Health Care)
Pain Measurement/*methods
Prevalence
Prospective Studies
Republic of Korea/epidemiology
Severity of Illness Index
Spinal Stenosis/epidemiology/*surgery
Surveys and Questionnaires
Treatment Outcome

Figure

• 

  Fig. 1 Proportion of patients with neuropathic pain by group (neuropathic pain was defined as a LANSS score greater than or equal to 12). LANSS, Leads Assessment of Neuropathic Symptoms and Signs.

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