The influence of psychologic factors on diskography in patients with chronic axial low back pain
Richard Derby1, Sang-Heon Lee, Yung Chen
1Spinal Diagnostics and Treatment Center, Daly City, CA, USA.
Objective:
To determine whether a patient's presenting psychometric scores affect the findings of a pressure and injection speed-controlled manometric lumbar diskography in patients with chronic low back pain (CLBP).
Design:
A prospective, correlation-based, investigative study.
Setting:
Free-standing ambulatory spine surgery center.
Participants:
Two hundred sixty-three disks from 81 patients (54 men, 27 women).
Intervention:
Diskography was performed using pressure and injection speed-controlled techniques. The patients were divided into psychometric subgroups (normal, at risk, abnormal) according to the Distress and Risk Assessment Method (DRAM).
Main Outcome Measures:
The diskography findings on each psychometric DRAM subgroup were evaluated.
Results:
Across the individual psychometric categories, the positive rates of diskography in the normal, at-risk, and abnormal subgroups were 75.0% (9/12), 59.5% (25/42), and 70.4% (19/27), respectively (P>.05). The mean numeric rating scores of pain at 15 and 50 psi above the opening pressure were similar in the 3 psychometric subgroups. There was no correlation between the diskography results and the psychometric subgroupings.
Conclusions:
In patients with CLBP, there is no correlation between the presenting psychometric DRAM score and the findings from pressure and injection speed-controlled manometric lumbar diskography.
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