Article

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.
CI - Copyright (c) 2015 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS