title: Prevalence and Location of Neuropathic Pain in Lumbar Spinal Disorders: Analysis of 1804 Consecutive Patients With Primary Lower Back Pain.
abstract: METHODS
  A cross-sectional study of 1804 consecutive patients.
  
  
  OBJECTIVE
  The aim of this study was to investigate the prevalence of pathological pain and its distribution features in patients with chronic lumbar spinal disorders.
  
  
  BACKGROUND
  Clinical spinal disorders can involve pathological neuropathic pain (NeP) as well as physiological nociceptive pain (NocP), as they have varied pathology, including spinal cord injury, stenosis, and compression. A study conducted by the Japanese Society for Spine Surgery and Related Research (JSSR) has determined a prevalence of 29.4% for NeP in patients with lumbar spinal disorder. However, the data did not include information on pain location.
  
  
  METHODS
  Patients aged 20 to 79 years with chronic lower back pain (≥3 months, visual analog scale score ≥30) were recruited from 137 JSSR-related institutions. Patient data included an NeP screening questionnaire score and pain location (lower back, buttock, and legs). The association between the pain pathology and its location was analyzed statistically using the unpaired t test and Chi-square test followed by Fisher test. P < 0.05 was considered significant.
  
  
  RESULTS
  Low back pain subjects showed 31.9% of NeP prevalence, and the pain distribution showed [NocP(%)/NeP(%)] low back pain only cases: 44/22, while low back pain with leg pain cases showed a prevalence of 56/78. This indicates that low back pain alone can significantly induce NocP rather than NeP (P < 0.01). Buttock pain was revealed to significantly induce both lower back pain and leg pain with NeP properties (P < 0.01). Leg pain was revealed to be predominantly neuropathic, especially when it included peripheral pain (P < 0.01).
  
  
  CONCLUSIONS
  Low back pain with no buttock pain induces NocP rather than NeP. Buttock pain is significantly associated with NeP prevalence whether or not leg pain exists. Leg pain can increase the prevalence of NeP, especially when it contains a peripheral element.
  
  
  METHODS
  3.
authors.affiliation: Department of Orthopaedic Surgery, Graduate school of Medicine, Chiba University.
authors.forename: Sumihisa
authors.initials: S
authors.lastname: Orita
authors.affiliation: Department of Orthopaedic Surgery, Sapporo Medical University, School of Medicine.
authors.forename: Toshihiko
authors.initials: T
authors.lastname: Yamashita
authors.affiliation: Department of Orthopaedic Surgery, Graduate school of Medicine, Chiba University.
authors.forename: Seiji
authors.initials: S
authors.lastname: Ohtori
authors.affiliation: Graduate School of Health Care Sciences, Jikei Institute, Osaka.
authors.forename: Kazuo
authors.initials: K
authors.lastname: Yonenobu
authors.affiliation: Department of Orthopaedic Surgery Spine Care Center, Wakayama Medical University Kihoku hospital.
authors.forename: Mamoru
authors.initials: M
authors.lastname: Kawakami
authors.affiliation: Department of Orthopaedic Surgery, Yamaguchi University Faculty of Medicine and Health Sciences.
authors.forename: Toshihiko
authors.initials: T
authors.lastname: Taguchi
authors.affiliation: Fukushima Medical University.
authors.forename: Shin-Ichi
authors.initials: SI
authors.lastname: Kikuchi
authors.affiliation: Aichi Medical University School of Medicine, Multidisciplinary Pain Center.
authors.forename: Takahiro
authors.initials: T
authors.lastname: Ushida
authors.affiliation: Fukushima Medical University.
authors.forename: Shin-Ichi
authors.initials: SI
authors.lastname: Konno
authors.affiliation: Department of Orthopaedic Surgery, Keio University, Tokyo.
authors.forename: Masaya
authors.initials: M
authors.lastname: Nakamura
authors.affiliation: Department of Orthopaedic Surgery, Fujino Orthopaedic Clinic, Shizuoka.
authors.forename: Keiji
authors.initials: K
authors.lastname: Fujino
authors.affiliation: Department of Orthopaedic Surgery, Kyoto University.
authors.forename: Shuichi
authors.initials: S
authors.lastname: Matsuda
authors.affiliation: Department of Rehabilitation and Physical Medicine, Kagoshima University, Japan.
authors.forename: Kazunori
authors.initials: K
authors.lastname: Yone
authors.affiliation: Department of Orthopaedic Surgery, Graduate school of Medicine, Chiba University.
authors.forename: Kazuhisa
authors.initials: K
authors.lastname: Takahashi
mesh_terms: D000328:Adult; D000368:Aged; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007866:Leg / Q000503:physiopathology; D017116:Low Back Pain / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology; D008159:Lumbar Vertebrae / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009437:Neuralgia / Q000453:epidemiology*; D015995:Prevalence; D013119:Spinal Cord Injuries / Q000150:complications / Q000453:epidemiology*; D013122:Spinal Diseases / Q000150:complications / Q000453:epidemiology*; D055815:Young Adult