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STUDY DESIGN A single-center retrospective study. OBJECTIVE To compare the speed of recovery of different sensory symptoms, pain, numbness, and paresthesia, after lumbar nerve root decompression. SUMMARY OF BACKGROUND DATA Lumbar radiculopathy is characterized by different sensory symptoms like pain, numbness, and paresthesia, which may resolve at different rates after surgical decompression. METHODS Eighty-five cases with predominant lumbar radiculopathy treated surgically were reviewed. Oswestry Disability Index score, 36-Item Short Form Health Survey scores (Physical Component Summary and Mental Component Summary), and pain drawing at preoperative and at 6 weeks, 3 months, 6 months, and 1-year follow-up were reviewed. Recovery rate between different sensory symptoms were compared in all patients, and between the short-term compression (

Study design This is a retrospective study of 250 patients who describe low back pain with pain drawings. A computer application using artificial neural networks was designed to analyze pain drawings and evaluate the contribution of pain sensation to drawing classification. Objective The primary goal of this study was to assess the contribution of patient recorded pain sensation marks in classifying pain drawings into one of five broadly defined categories. The hypothesis was that including pain sensation would improve classification. Summary of background data With no perfect diagnostic test for patients with low back pain, many approaches have been proposed and are used. One common diagnostic tool is the pain drawing. Several quantitative methods have been proposed to score the drawings. Some methods use pain sensation in the scoring; however, the contribution of pain sensation has not been defined. Methods A custom computer application classified the pain drawing. Data consisted of 250 pain drawings from patients with low back pain. Results Patient recorded pain sensation is not necessary in computer-based scoring of pain drawings. Conclusion Patient-reported pain sensation does not improve classification when quantitatively scoring pain drawings.

Prospective comparative study of pain drawings with findings on lumbar spine magnetic resonance imaging.To assess the ability of the pain drawing to predict the presence of nerve root compression.Most research work has concentrated on the ability of the pain drawing to act as a screening method for psychological distress with less work directed at the influence the anatomic abnormality has on the pain drawing.One hundred thirty-four consecutive outpatients attending for lumbar magnetic resonance imaging in the investigation of back and leg pain completed pain drawings and psychological testing immediately before the examination. The pain drawing was analyzed by previously reported criteria, and the magnetic resonance imaging was assessed independently for the presence of nerve compression by three radiologists. Multivariate stepwise discriminant analysis was used to identify patients with nerve compression on the basis of their pain drawing.Nerve compression was predicted by numbness in the anterolateral aspect of the foot. There was considerable overlap in the appearances of the pain drawings between patients with and without nerve compression, and the pain drawing correctly classified only 58% of patients with nerve compression.The pain drawing is not a good predictor of nerve compression on magnetic resonance imaging in a group of patients investigated for back and leg pain. It should be interpreted with caution and in light of the full clinical picture.

Patient pain drawings were blindly selected from five lumbar spine disorder categories. The drawings were classified by low-back physicians, discriminant analysis, and several computerized artificial neural network configurations. The purpose was to determine the reliability of the patient pain drawing when diagnosing low-back disorders and to delineate the pain mark patterns particular to each disorder by comparing physicians with computerized methods. The physicians averaged 51% accuracy with individual preferences for certain disorder groups. The computerized methods demonstrated comparable accuracy (48%) and more agreement in classification. Associations were found between the predicted pain patterns for each diagnostic group made by an expert and the patterns generated by computerized methods. Variances in these associations are instructive to clinicians for making accurate predictions of diagnosis from pain drawings.

Pain drawings were obtained from a group of 651 patients who had chronic low-back pain. Pain drawings were rated in four grades according to the degree of organic and nonorganic pain. Experienced and inexperienced evaluators were used. The reliability was excellent with an interevaluator reliability between 73% and 78%. A correlation between pain drawings and Waddell's nonorganic physical signs demonstrated that a large proportion of patients with high Waddell scores had nonorganic pain drawings. No significant differences were noted in the distribution of Waddell scores and pain drawings based on patient gender or payment status (i.e., medicolegal or workers' compensation). Pain drawings afford an important adjunct in the physician's assessment of chronic low-back pain.

Sixty-nine patients who had completed a Minnesota Multiphasic Personality inventory (MMPI) test preoperatively and had had low-back surgery for discogenic disease were seen in follow-up one to 11 years later. Each completed an MMPI test and pain drawing postoperatively, was examined clinically and radiographically, and was rated for surgical outcome. The preoperative MMPI hypochondriasis (Hs) and hysteria (Hy) scales were only modestly related to treatment outcome, but the postoperative scales were strongly related to outcome. Patients with good surgical outcome had lower Hs and Hy scores postoperatively than preoperatively, whereas patients with poor outcomes had higher Hs and Hy scores postoperatively. The MMPI profile of these operated low-back-pain patients was found to be changeable rather than static. The numerical value of the pain drawings was highly correlated with the elevation of the Hs or Hy scales. The MMPI should be utilized to identify patients with neurotic tendencies and prompt referral for psychologic treatment. Those patients who respond favorably to psychotherapy tend to have a better surgical outcome than those with untreated psychoneuroses or those who fail to improve with treatment.

A study was undertaken to evaluate the possibility of using the pain drawing of a patient with low-back pain as a screening test to determine whether further psychologic evaluation was necessary. Using the analysis described, the pain drawing predicted a high or low hypochondriasis or hysteria scale

Pain drawings were obtained from two groups of patients and one of nonpatients, in a total of 264 subjects, all suffering from back pain. The pain drawings were rated in four grades according to the degree of nonorganic and extended pain. The reliability was excellent with an intra- and interrater agreement of 80 and 70%, respectively. Three quarters of the nonpatient group had dull aching pain in the lower back only, whereas widespread or nonanatomical pain was prevalent in patients responding poorly to treatment. A correlation was also found to ethnic background and social situation but not to alcohol abuse or psychiatric illness. Pain drawings afford an important clue to nonorganic factors in the assessment of back pain.