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.