Archives of Physical Medicine and Rehabilitation
Volume 89, Issue 7 , Pages 1300-1304, July 2008

The Influence of Psychologic Factors on Diskography in Patients With Chronic Axial Low Back Pain

  • Richard Derby, MD

      Affiliations

    • Spinal Diagnostics and Treatment Center, Daly City, CA
    • Division of Physical Medicine and Rehabilitation, Stanford University Medical Center, Stanford, CA
  • ,
  • Sang-Heon Lee, MD, PhD

      Affiliations

    • Spinal Diagnostics and Treatment Center, Daly City, CA
    • Department of Rehabilitation Medicine, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Korea
  • ,
  • Yung Chen, MD

      Affiliations

    • Spinal Diagnostics and Treatment Center, Daly City, CA
  • ,
  • Byung-Jo Kim, MD, PhD

      Affiliations

    • Spinal Diagnostics and Treatment Center, Daly City, CA
    • Department of Neurology, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Korea
  • ,
  • Chang-Hyung Lee, MD, PhD

      Affiliations

    • Korea National Training Center, Seoul, Korea
  • ,
  • Young-Ki Hong, MD

      Affiliations

    • Graduate School of Medicine, Korea University, Seoul, Korea.
  • ,
  • Jeong-Eun Lee, PT

      Affiliations

    • Department of Rehabilitation Medicine, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Korea
  • ,
  • Kwan-Sik Seo, MD, PhD

      Affiliations

    • Department of Rehabilitation Medicine, Seoul National University Hospital, Seoul, Korea
    • Corresponding Author InformationReprint requests to Kwan-Sik Seo, MD, PhD, Dept of Rehabilitation Medicine, Seoul National University Hospital, 28, Yeongundong Jongrogu, Seoul, 110-744, Korea

Abstract 

Derby R, Lee S-H, Chen Y, Kim B-J, Lee C-H, Hong Y-K, Lee J-E, Seo K-S. The influence of psychologic factors on diskography in patients with chronic axial low back pain.

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 50psi 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.

Key Words: Intervertebral disk, Low back pain, Psychometrics, Rehabilitation

List of Abbreviations: CLBP, chronic low back pain, CT, computed tomography, DRAM, Distress and Risk Assessment Method, MRI, magnetic resonance imaging, MSPQ, Modified Somatic Pain Questionnaire, NRS, numeric rating scale, ZSDS, Zung Self-Rated Depression Scale

 

 No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit upon the authors or upon any organization with which the authors are associated.

PII: S0003-9993(08)00231-1

doi:10.1016/j.apmr.2007.11.043

Archives of Physical Medicine and Rehabilitation
Volume 89, Issue 7 , Pages 1300-1304, July 2008