The value of quantitative sensory testing in spine research

Neurosurg Rev. 2017 Jul;40(3):411-418. doi: 10.1007/s10143-016-0798-4. Epub 2016 Nov 28.

Abstract

The improvement of pain and functionality is the major goal of a surgical intervention. Thus, the purpose of the present prospective study was to evaluate whether subjective sensory deficits in patients with lumbar radiculopathy caused by a lumbar disc herniation are related to clinical status, using several outcome scores and the quantitative sensory testing (QST) pre- and 12 months postoperatively. We applied the QST in 52 patients with a single lumbar disc herniation treated by lumbar sequestrectomy pre- and 12 months postoperatively. Further evaluation included numeric rating scale (NRS) for leg, EuroQoL-5D (EQ-5D), Core Outcome Measure Index (COMI), Oswestry Disability Index (ODI), Beck Depression Inventory (BDI) and PaindDetect questionnaire (PD-Q). Patients were then categorized into two groups based on their subjective recovery of sensory function. The patients' self-assessment and QST were correlated with each other for the pre- and postoperative visit after 12 months. The two groups showed postoperative differences in mechanical and vibration detection threshold as well as in the postoperative PD-Q (p < 0.005). Multidimensional scores did not consistently match the QST parameters in patients with a lumbar disc herniation. Commonly used clinical scores in spine research show low or no correlation with QST. Nevertheless, mechanical thresholds seem to play an important role to detect and follow up a sensory deficit investigated by QST.

Keywords: Disc herniation; Lumbar sequestrectomy; Quantitative sensory testing; Radiculopathy; Spine research.

Publication types

  • Observational Study

MeSH terms

  • Adult
  • Aged
  • Depression / etiology
  • Depression / psychology
  • Disability Evaluation
  • Female
  • Humans
  • Intervertebral Disc Displacement / complications
  • Intervertebral Disc Displacement / surgery
  • Lumbar Vertebrae
  • Male
  • Middle Aged
  • Neurosurgical Procedures / methods
  • Pain / etiology
  • Pain Measurement / methods
  • Prospective Studies
  • Radiculopathy / complications*
  • Self-Assessment
  • Sensation Disorders / diagnosis*
  • Sensation Disorders / etiology*
  • Sensation Disorders / psychology
  • Sensory Thresholds
  • Treatment Outcome