Asian Spine J.  2017 Dec;11(6):917-927. 10.4184/asj.2017.11.6.917.

Prevalence of Neuropathic Pain and Patient-Reported Outcomes in Korean Adults with Chronic Low Back Pain Resulting from Neuropathic Low Back Pain

Affiliations
  • 1Department of Orthopedic Surgery , Inje University Ilsan Paik Hospital, Goyang, Korea.
  • 2Department of Neurosurgery, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
  • 3Department of Orthopedic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. csl3503@skku.edu
  • 4Department of Neurosurgery, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea. SPINEKKS@yuhs.ac
  • 5Department of Orthopedic Surgery, Gangnam Severance Hospital, Yonsei University Health System, Seoul, Korea.
  • 6Department of Orthopedic Surgery, Inje University Sanggye Paik Hospital, Seoul, Korea.
  • 7Department of Orthopedic Surgery, Hanyang University Guri Hospital, Guri, Korea.
  • 8Department of Orthopedic Surgery, Seoul National University Hospital, Seoul, Korea.
  • 9Department of Orthopedic Surgery, Gachon Universtiy Gil Medical Center, Incheon, Korea.
  • 10Department of Orthopedic Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
  • 11Department of Orthopedic Surgery, Kyung Hee University Hospital, Seoul, Korea.
  • 12Department of Orthopedic Surgery, Kyungpook National University Hospital, Daegu, Korea.
  • 13Department of Orthopedic Surgery, Pusan National University Hospital, Busan, Korea.
  • 14Department of Orthopedic Surgery, Korea University Anam Hospital, Seoul, Korea.
  • 15Department of Orthopedic Surgery, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Incheon, Korea.
  • 16Department of Orthopedic Surgery, Korea University Ansan Hospital, Ansan, Korea.
  • 17Department of Neurosurgery, Kangbuk Samsung Hospital, Seoul, Korea.
  • 18Department of Neurosurgery, Gachon University Gil Medical Center, Incheon, Korea.
  • 19Department of Neurosurgery, Korea University Guro Hospital, Seoul, Korea.
  • 20Department of Neurosurgery, Chonnam National University Hospital, Gwangju, Korea.
  • 21Department of Neurosurgery, Keimyung University Dongsan Hospital, Daegu, Korea.
  • 22Department of Neurosurgery, Severance Hospital, Yonsei University Health System, Seoul, Korea.
  • 23Department of Neurosurgery, Soonchunhyang University Bucheon Hospital, Bucheon, Korea.
  • 24Department of Neurosurgery, Yeungnam University Medical Center, Daegu, Korea.
  • 25Department of Neurosurgery, Pusan National University Hospital, Busan, Korea.
  • 26Department of Neurosurgery, Inje University Sanggye Paik Hospital, Seoul, Korea.
  • 27Department of Neurosurgery, Sun Medical Center, Daejeon, Korea.
  • 28Outcomes Research/Real World Data, Corporate Affairs & Health and Value, Pfizer Pharmaceuticals Korea Ltd., Seoul, Korea.
  • 29Department of Biostatistics, College of Medicine, Korea University, Seoul, Korea.

Abstract

STUDY DESIGN: A noninterventional, multicenter, cross-sectional study. PURPOSE: We investigated the prevalence of neuropathic pain (NP) and patient-reported outcomes (PROs) of the quality of life (QoL) and functional disability in Korean adults with chronic low back pain (CLBP). OVERVIEW OF LITERATURE: Among patients with CLBP, 20%-55% had NP.
METHODS
Patients older than 20 years with CLBP lasting for longer than three months, with a visual analog scale (VAS) pain score higher than four, and with pain medications being used for at least four weeks before enrollment were recruited from 27 general hospitals between December 2014 and May 2015. Medical chart reviews were performed to collect demographic/clinical features and diagnosis of NP (douleur neuropathique 4, DN4). The QoL (EuroQoL 5-dimension, EQ-5D; EQ-VAS) and functional disability (Quebec Back Pain Disability Scale, QBPDS) were determined through patient surveys. Multiple linear regression analyses were performed to compare PROs between the NP (DN4≥4) and non-NP (DN4 < 4) groups.
RESULTS
A total of 1,200 patients (females: 65.7%; mean age: 63.4±13.0 years) were enrolled. The mean scores of EQ-5D, EQ-VAS, and QBPDS were 0.5±0.3, 55.7±19.4, and 40.4±21.1, respectively. Among all patients, 492 (41.0%; 95% confidence interval, 38.2%-43.8%) suffered from NP. The prevalence of NP was higher in male patients (46.8%; p < 0.01), in patients who had pain based on radiological and neurological findings (59.0%; p < 0.01), and in patients who had severe pain (49.0%; p < 0.01). There were significant mean differences in EQ-5D (NP group vs. non-NP group: 0.4±0.3 vs. 0.5±0.3; p < 0.01) and QBPDS (NP group vs. non-NP group: 45.8±21.2 vs. 36.3±20.2; p < 0.01) scores. In the multiple linear regression, patients with NP showed lower EQ-5D (β=−0.1; p < 0.01) and higher QBPDS (β=7.0; p < 0.01) scores than those without NP.
CONCLUSIONS
NP was highly prevalent in Korean patients with CLBP. Patients with CLBP having NP had a lower QoL and more severe dysfunction than those without NP. To enhance the QoL and functional status of patients with CLBP, this study highlights the importance of appropriately diagnosing and treating NP.

Keyword

Chronic low back pain; Neuralgia; Prevalence; Quality of life

MeSH Terms

Adult*
Back Pain
Cross-Sectional Studies
Diagnosis
Hospitals, General
Humans
Linear Models
Low Back Pain*
Male
Neuralgia*
Prevalence*
Quality of Life
Visual Analog Scale
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