Cluster analysis of SF-36 scales as a predictor of spinal pain patients response to a multidisciplinary pain management approach beginning with epidural steroid injection.
OBJECTIVE
To investigate whether grouping of patients with back pain into similar behavioral patient profiles using SF-36 scores is predictive of outcome following 1-year treatment in a multidisciplinary spine center beginning with referral for epidural steroid injection.


METHODS
A prospective observational study was conducted on 81 consecutive patients selected for epidural steroid injections by independent physicians following common institutional criteria. Each patient completed a baseline SF-36 questionnaire as well as a numerical response pain scale. The initial SF-36 data were used to place each patient into one of three subgroups (Highly Functional, Emotional Adapters, and Dysfunctional). Follow-up SF-36 and numerical response pain scale questionnaires were completed by the patients at 1 month and 12 months following the initial epidural steroid injection.


RESULTS
Results revealed significant improvement among all three patient subgroups following multidisciplinary treatment at both 1 month and 12 months. Few differences in outcome occurred among the subgroups.


CONCLUSIONS
The SF-36-determined subgroups did not predict response to a multidisciplinary pain clinic. All three subgroups showed similar improvement following treatment.
Loyd
Ryan
R
Department of Anesthesiology, Dartmouth-Hitchcock Medical Center, Lebanon, NH 03756, USA.
Fanciullo
Gilbert J
GJ
Hanscom
Brett
B
Baird
John C
JC
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000700:Analgesics / Q000008:administration & dosage; D001416:Back Pain / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology*; D016000:Cluster Analysis; D005260:Female; D006801:Humans; D007268:Injections, Epidural / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D009513:New Hampshire / Q000453:epidemiology; D017063:Outcome Assessment, Health Care / Q000379:methods*; D018710:Pain Clinics / Q000706:statistics & numerical data; D010147:Pain Measurement / Q000379:methods*; D011379:Prognosis; D011569:Psychiatric Status Rating Scales; D011788:Quality of Life; D015203:Reproducibility of Results; D018570:Risk Assessment / Q000379:methods*; D012307:Risk Factors; D012680:Sensitivity and Specificity; D013253:Steroid 12-alpha-Hydroxylase; D013256:Steroids / Q000008:administration & dosage*; D011795:Surveys and Questionnaires; D016896:Treatment Outcome
D000700:Analgesics; D013256:Steroids; D013253:Steroid 12-alpha-Hydroxylase