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

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. [Copyright &y& Elsevier]