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Nonorganic Pain Drawings Linked to Inferior Outcomes

Predict negative satisfaction in patients after lumbar spinal fusion surgery

THURSDAY, May 20 (HealthDay News) -- A nonorganic pain drawing used during lumbar spinal fusion surgery is a significant risk factor for inferior outcome, according to a study published in the May issue of The Spine Journal.

Thomas Andersen, M.D., Ph.D., of Aarhus University Hospital in Denmark, and colleagues evaluated 135 individuals (57 men and 78 women) to assess the predictive value of pain drawings regarding outcome after lumbar spinal fusion surgery. The outcome measures were Dallas Pain Questionnaire (DPQ), Low Back Pain Rating Scale (LBPRS) pain index and patient satisfaction.

The researchers found that 33 percent of the drawings were classified as nonorganic. Nonorganic drawings were linked to significantly higher DPQ and LBPRS scores before surgery and at follow-up. While a nonorganic pain drawing predicted negative patient satisfaction (odds ratio (OR) = 3.01), the drawing had no significant predictive value with respect to LBPRS pain index improvement. In addition, nonorganic pain drawings were linked to poorer outcomes in patients with low back pain and radicular symptoms but not in patients without radicular symptoms.

"The pain drawing does not qualify for selection of patients for lumbar spinal fusion with respect to securing a good outcome," the authors write. "It is, however, a significant risk factor for inferior results of a magnitude comparable to other known risk factors, such as ongoing compensation/legal case, poor work status, and smoking."

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