Pain Sensitivity and Pain Catastrophizing Are Associated With Persistent Pain and Disability After Lumbar Spine Surgery.

Journal Article (Journal Article)

OBJECTIVE: To examine whether pain sensitivity and pain catastrophizing are associated with persistent pain and disability after lumbar spine surgery. DESIGN: Prospective observational cohort study. SETTING: Academic medical center. PARTICIPANTS: Patients (N=68; mean age, 57.9±13.1y; 40 women [58.8%]) undergoing spine surgery for a degenerative condition from March 1, 2012 to April 30, 2013 were assessed 6 weeks, 3 months, and 6 months after surgery. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: The main outcome measures were persistent back pain intensity, pain interference, and disability. Patients with persistent back pain intensity, pain interference, or disability were identified as those patients reporting Brief Pain Inventory scores ≥4 and Oswestry Disability Index scores ≥21 at all postoperative time points. RESULTS: From 6 weeks to 6 months after surgery, approximately 12.9%, 24.2%, and 46.8% of patients reported persistent back pain intensity, pain interference, or disability, respectively. Increased pain sensitivity at 6 weeks was associated with having persistent back pain intensity (odds ratio [OR], 2.0; 95% confidence interval [CI], 1.0-4.1) after surgery. Increased pain catastrophizing at 6 weeks was associated with having persistent back pain intensity (OR, 1.1; 95% CI, 1.0-1.2), pain interference (OR, 1.1; 95% CI, 1.0-1.2), and disability (OR, 1.3; 95% CI, 1.1-1.4). An interaction effect was not found between pain sensitivity and pain catastrophizing on persistent outcomes (P>.05). CONCLUSIONS: The findings suggest the importance of early postoperative screening for pain sensitivity and pain catastrophizing to identify patients at risk for poor postoperative pain intensity, pain interference, and/or disability outcomes. Future research should consider the benefit of targeted therapeutic strategies for patients with these postoperative prognostic factors.

Full Text

Duke Authors

Cited Authors

  • Coronado, RA; George, SZ; Devin, CJ; Wegener, ST; Archer, KR

Published Date

  • October 2015

Published In

Volume / Issue

  • 96 / 10

Start / End Page

  • 1763 - 1770

PubMed ID

  • 26101845

Pubmed Central ID

  • PMC4601931

Electronic International Standard Serial Number (EISSN)

  • 1532-821X

Digital Object Identifier (DOI)

  • 10.1016/j.apmr.2015.06.003


  • eng

Conference Location

  • United States