Failed Back Surgery Syndrome and Back Pain Patients: Medications They use and How They relate to Their Emotional and Physical Functioning

Abstract

ABSTRACTStudy DesignRetrospective analysis.ObjectiveTo test the hypothesis that failed back surgery syndrome (FBSS) patients and nonsurgical back pain (NSBP) patients respond differently on psychological measures and differ in pain medication usage.Summary of background dataThe study was part of an inter disciplinary outpatient functional restoration program. There were 121 participants—42 with FBSS and 79 with NSBP—who participated in a multidisciplinary pain evaluation.MethodsA chart review was performed and interventions were not applicable. The outcome measures for the study include: the beck depression inventory (BDI), pain disability index (PDI), statetrait anxiety inventory (STAI), multidimen sional pain inventory pain severity (MPIPS) subscale and medication quantification scale III (MQS-III).ResultsPearson's correlation analyses of all patients com bined (28 FBSS and 39 NSBP) revealed significant relationships between MQS-III and BDI (r = 0.388, p < 0.01) and STAI (r = 0.323, p < 0.05). A significant correlation was found between MQS-III and STAI (r = 0.536, p < 0.05) among the NSBP patients. The MQS-III was significantly correlated with BDI (r = 0.536, p < 0.05) and MPI-PS t-scores (r = 0.356, p < 0.05) among the 40 NSBP patients. Independent ttests of mean BDI, PDI, STAI, MPIPS, and MQS-III scores revealed no significant group differences.ConclusionResults suggest that while there is differing cor relation between FBSS and NSBP groups in pain medication use and psychometrics, the mean difference of quantity of pain medications used and scores on psychometric measure ments in these groups are not different. While presurgical psychometrics and pain medication usage were not available for our FBSS patients, our results support that medication quantification with psychological prescreening before surgical intervention for back pain patients may help to limit the number of failed back surgeries. Thus, future research including pre and postsurgical psychological functioning, physical functioning, and pain medication usage is suggested.Gallizzi MA, Gagnon CM, Blizzard DJ, Stanos SP. Failed Back Surgery Syndrome and Back Pain Patients: Medications They use and How They relate to Their Emotional and Physical Functioning. The Duke Orthop J 2015;5(1):53-57.