title: The influence of pain sensitivity on the treatment outcome of transforaminal epidural steroid injection in patients with lumbar spinal stenosis.
abstract: The aim of this study was to investigate the effect of individual pain sensitivity on the results of transforaminal epidural steroid injection (TFESI) for the patients with lumbar spinal stenosis (LSS). Seventy-seven patients with LSS were included in this study. Prospectively planned evaluations were performed twice consecutively before and 2 months after TFESI. These included a detailed medical history, a physical examination, and completion of a series of questionnaires, including pain sensitivity questionnaire (PSQ), Oswestry disability index (ODI), and visual analog scale (VAS) for back and leg pain. The correlations were analyzed among variables between total PSQ/PSQ-moderate/PSQ-minor and pain and disability level measured by VAS for back/leg pain and ODI both before and 2 months after TFESI. Two months after TFESI, there were significant decreases in VAS for back/leg pain and ODI compared with those before injection. Before injection, VAS for back pain and leg pain was highly associated with the PSQ scores including total PSQ and PSQ subscores after adjustment for age, BMI, and grade of canal stenosis. However, any subscores of PSQ and total PSQ scores were not correlated with either VAS for back pain/leg pain or ODI 2 months after TFESI with adjustment made to age, BMI, gender, and grade of canal stenosis. This study highlights that individual pain sensitivity does not influence the outcomes of TFESI treatment in patients with LSS, even though pain sensitivity has a significant negative correlation with symptom severity of LSS.
authors.affiliation: Spine Center and Department of Orthopaedic Surgery, Seoul National University College of Medicine and Seoul National University Bundang Hospital, Sung-Nam, Korea.
authors.forename: Ho-Joong
authors.initials: HJ
authors.lastname: Kim
authors.forename: Jin S
authors.initials: JS
authors.lastname: Yeom
authors.forename: Joon Woo
authors.initials: JW
authors.lastname: Lee
authors.forename: Bong-Soon
authors.initials: BS
authors.lastname: Chang
authors.forename: Choon-Ki
authors.initials: CK
authors.lastname: Lee
authors.forename: Gun-Woo
authors.initials: GW
authors.lastname: Lee
authors.forename: Seung-Bin
authors.initials: SB
authors.lastname: Im
authors.forename: Han Jo
authors.initials: HJ
authors.lastname: Kim
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001416:Back Pain / Q000175:diagnosis / Q000188:drug therapy* / Q000523:psychology; D006801:Humans; D007268:Injections, Epidural / Q000009:adverse effects; D008159:Lumbar Vertebrae; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement / Q000187:drug effects / Q000379:methods* / Q000523:psychology; D013130:Spinal Stenosis / Q000175:diagnosis / Q000188:drug therapy* / Q000523:psychology; D013256:Steroids / Q000008:administration & dosage* / Q000009:adverse effects; D016896:Treatment Outcome
chemical_list: D013256:Steroids
keywords: Oswestry Disability Index; Visual Analog Pain Scale; lumbar spinalstenosis; pain measurement; pain sensitivity; sciatica; transforaminal epidural steroid injection