Cold pain hypersensitivity predicts trajectories of pain and disability after low back surgery: a prospective cohort study

Monika Müller, Lukas Bütikofer, Ole K. Andersen, Paul Heini, Lars Arendt-Nielsen, Peter Jüni, Michele Curatolo

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Abstrakt

Improving the ability to predict persistent pain after spine surgery would allow identification of patients at risk and guide treatment decisions. Quantitative sensory tests (QST) are measures of altered pain processes, but in our previous study preoperative QST did not predict pain and disability at single time-points. Trajectory analysis accounts for time-dependent patterns. We hypothesized that QST predict trajectories of pain and disability during one year after low back surgery. We performed a trajectory analysis on the cohort of our previous study (n=141). Baseline QST included electrical, pressure, heat and cold stimulation of the low back and lower extremity, temporal summation and conditioned pain modulation. Pain intensity and Oswestry Disability Index were measured before, 2, 6 and 12 months after surgery. Bivariate trajectories for pain and disability were computed using group-based trajectory models. Multivariable regressions were used to identify QST as predictors of trajectory-groups, with sociodemographic, psychological and clinical characteristics as covariates. Cold pain hypersensitivity at the leg, not being married and long pain duration independently predicted worse recovery (complete-to-incomplete, incomplete-to-no recovery). Cold pain hypersensitivity increased the odds for worse recovery by 3.8 (95% CI 1.8−8.0, p
OriginalsprogEngelsk
TidsskriftPain
ISSN0304-3959
DOI
StatusE-pub ahead of print - 28 jul. 2020

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