Advances in Clinical and Experimental Medicine

Title abbreviation: Adv Clin Exp Med
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ISSN 1899–5276 (print)
ISSN 2451-2680 (online)
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Advances in Clinical and Experimental Medicine

2013, vol. 22, nr 3, May-June, p. 411–419

Publication type: original article

Language: English

Evaluation of Pain in Patients with Lumbar Disc Surgery Using VAS Scale and Quantitative Sensory Testing

Ocena bólu u pacjentów operowanych z powodu dyskopatii lędźwiowej za pomocą skali VAS i ilościowego pomiaru czucia

Lesław W. Zub1,B,C,F, Małgorzata Szymczyk2,B,C,D, Anna Pokryszko-Dragan2,B,C, Małgorzata Bilińska2,A,E,F

1 Department of Neurosurgery, Wroclaw Medical University, Poland

2 Department of Neurology, Wroclaw Medical University, Poland

Abstract

Abstract
Background. Pain is interpreted at the cortex level, however, pain signaling stimuli arise at the periphery and are conveyed by nociceptive A delta and C fibers.
Objectives. Evaluation of pain using the VAS scale in pre- and postoperative S1 sciatica patients with regard to thermal thresholds in the corresponding dermatome.
Material and Methods. Twenty-six S1 sciatica patients with herniated disc on an MRI, non-responsive to con- servative care, were involved in the study. Pain in the affected leg was measured using the VAS scale and thermal thresholds in S1 symptomatic dermatome using Quantitative Sensory Testing (QST).
Results. Pain intensity as well as thermal thresholds were increased in sciatica patients compared to controls. Disc surgery resulted in a pronounced lowering of pain in each of the operated patients. From the whole group, 21 subjects were examined postoperatively six months later. In the group with complete clinical recovery, thermal thresholds were within normal limits. In those patients with residual pain disability, normalization of thresholds has not been achieved
Conclusions. Pain in sciatica patients may be objectively measured by QST (Adv Clin Exp Med 2013, 22, 3, 411–419).


 

Streszczenie

Streszczenie
Wprowadzenie. Ból jest zjawiskiem złożonym i jego interpretacja następuje na poziomie kory mózgowej, do której informacja o szkodliwych bodźcach jest przewodzona z obwodu nocyceptywnymi włóknami A delta i C.
Cel pracy. Ocena bólu z wykorzystaniem skali VAS w odniesieniu do funkcji włókien A delta i C w uszkodzonym der- matomie u chorych z jednopoziomowym bólowym zespołem korzeniowym przed i po zabiegu dekompresji korzenia. Materiał i metody. 26 chorych na ischialgię S1, nieodpowiadających na leczenie zachowawcze, z potwierdzonym uciskiem korzenia przez dysk poddano zabiegom discektomii. Ból w zajętej kończynie oceniano w skali VAS, a progi czucia metodą ilościowego pomiaru (QST) w dermatomie S1 bezpośrednio przed i 6 miesięcy po zabiegu. Wyniki. U wszystkich chorych przed zabiegiem wykazano podwyższenie progów czucia. Po zabiegu u wszystkich badanych intensywność bólu znacznie zmalała. 21 chorych poddano powtórnym badaniom 6 miesięcy po zabiegu. U pacjentów z całkowitym ustąpieniem bólów progi wróciły do wartości prawidłowej. U chorych z niepełną popra- wą progi czucia pozostały nieprawidłowe.
Wnioski. Badanie progów czucia metodą QST może służyć obiektywizacji doznań bólowych (Adv Clin Exp Med
2013, 22, 3, 411–419).

 

Key words

Key words: monoradicular sciatica, VAS scale, QST, disc surgery.

Słowa kluczowe

Słowa kluczowe: jednopoziomowe uszkodzenie korzeniowe, skala VAS, ilościowy pomiar czucia (QST), dekom- presja korzenia.

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