Cut-Off Value for Pain Sensitivity Questionnaire in Predicting Surgical Success in Patients with Lumbar Disc Herniation

<div><p>Various factors related to predict surgical success were studied; however, a standard cut-off point for the Pain Sensitivity Questionnaire (PSQ) measure has not yet been established for a favorable surgical outcome for lumbar disc herniation (LDH). This study was to find the optimal cut-off point on the PSQ to distinguish surgical success in patients with LDH. A total of 154 patients with LDH consecutively referred to our clinic were enrolled into this prospective study between February 2011 and January 2014. All participants completed the PSQ. Patients completed the Oswestry Disability Index (ODI) score before surgery, and at 2 years after surgery. Surgical success was defined as a 13-point improvement from the baseline ODI scores. The cut-off value for PSQ was determined by the receiver-operating characteristic curve (ROC). The mean age of patients was 49.3±9.6 years, and there were 80 women. The mean time for follow-up assessment was 31±5 months (range 24–35). Post-surgical success was 79.9% (n = 123) at 2 years follow up. The mean score for the total PSQ, PSQ-minor, and PSQ-moderate were 6.0 (SD = 1.6), 5.4 (SD = 1.9) and 6.5 (SD = 1.7), respectively. Total PSQ score was also significantly correlated with the total scores of the ODI. The optimal total PSQ cut-off point was determined as > 5.2 to predict surgical success in LDH patients, with 80.0% sensitivity and 75.6% specificity (AUC-0.814, 95% CI 0.703–0.926). This study showed that the PSQ could be considered a parameter for predicting surgical success in patients with LDH, and can be useful in clinical practice.</p></div

ROC Curve for the total PSQ as a predictor of surgical success in patients with LDH (AUC-0.814, 95% CI 0.703–0.926; P < 0.001).

<p>The optimal cut-off for maximum sensitivity and specificity was > 5.2.</p

Two-by-two matrices of the relationship between the estimated dissatisfied and the actual dissatisfied (sensitivity analysis).

<p>Two-by-two matrices of the relationship between the estimated dissatisfied and the actual dissatisfied (sensitivity analysis).</p

Two-by-two matrices of the relationship between the estimated satisfied and the actual satisfied (sensitivity analysis).

<p>Two-by-two matrices of the relationship between the estimated satisfied and the actual satisfied (sensitivity analysis).</p

Demographic data and preoperative status of patients with lumbar disc herniation (n = 154).

<p>Demographic data and preoperative status of patients with lumbar disc herniation (n = 154).</p

Outcomes by type of stenosis based on SSS Q13–Q18 score in patients with lumbar spinal canal stenosis (n = 96).

<p>Outcomes by type of stenosis based on SSS Q13–Q18 score in patients with lumbar spinal canal stenosis (n = 96).</p