Prospektive, psychodiagnostische Erfassung von Problemverlaeufen bei lumbalem Bandscheibenvorfall. Eine multizentrische Studie zur Erfassung der klinischen Einsetzbarkeit und prospektiven Validitaet Abschlussbericht

Aims of the study were: (1) to investigate the prognostic value of pain history, sociodemographic, psychodiagnostic and medical factors for the long-term outcome after lumbar disc surgery and (2) to develop a screening check list of reliable predictors which distinguish between good and bad outcomes. In six different spine centers 752 patients (679; 90,8% with disc herniation) were assessed after indication for operation by independent research teams. Follow-ups were performed six and 12 months later (80% of the population) or only two years postoperatively (20% of the population) and more than 80% of the patients participated. Between 18% and 25% of the patients reported severe back pain (VAS > = 7) at the follow-up examinations. In order to identify relevant predictors, the preoperatively obtained data of patients with no, to moderate back pain (0-6 VAS) and those with severe back pain (7-10 VAS) were compared. Using multivariate discriminant analysis 74% to 87% of the patients were correctly classified. The most important predictors were found to be: duration of subjectively reduced working capability, number of other pain locations, intensity of restricted physical mobility, depression and consideration or application for disability pension. On the value basis of this statistical analysis, the predictors were converted to scores, reflecting their relative significance and a predictor-sum was calculated for each patient. The probability of (chronic) severe back pain after discetomy increased with a higher predictor-sum to more than 80%. In conclusion, it is possible to determine a predictor-sum for each patient which is prognostic for the individual risk of a postoperative chronification of low back pain. (orig.)SIGLEAvailable from TIB Hannover: F95B526+a / FIZ - Fachinformationszzentrum Karlsruhe / TIB - Technische InformationsbibliothekBundesministerium fuer Forschung und Technologie (BMFT), Bonn (Germany)DEGerman