Abstract：
BACKGROUND: Superior/middle cluneal nerve entrapment (CN-E) is an elicitor of low back pain (LBP). The painDETECT questionnaire is used to characterize CN-E symptoms.
METHODS: Nineteen consecutive patients with LBP caused by CN-E (superior CN-E = 7; middle CN-E = 12) participated in a Japanese language painDETECT questionnaire survey before surgery. A score of 12 or lower was recorded as \'neuropathic component unlikely\', a score of 19 or higher as \'neuropathic pain likely\', and scores between 13 and 18 as \'neuropathic pain possible\'. LBP severity was recorded on a numerical rating scale, the Roland-Morris Disability Questionnaire, and the EuroQol-5 dimension-5 level.
RESULTS: The mean painDETECT score was 11.8 and did not significantly differ between the superior CN-E and middle CN-E groups. We classified low back pain as unlikely to have a neuropathic component in 13 patients, as likely to have a neuropathic component in 2 patients, and as possibly neuropathic in 4 patients. There was no significant difference in the pain level of patients with scores of ≤12 and ≥13 on painDETECT. All patients reported trigger pain; the positive rate was high for electric shock pain, radiating pain, and pain attacks and low for a burning or tingling sensation, pain elicited by a light touch, and pain caused by cold or hot stimulation.
CONCLUSIONS: The painDETECT questionnaire may not reliably identify LBP caused by superior/middle CN-E as neuropathic pain. A diagnosis of LBP due to CN-E must be made carefully because symptoms resemble nociceptive pain.
METHODS: Nineteen consecutive patients with LBP caused by CN-E (superior CN-E = 7; middle CN-E = 12) participated in a Japanese language painDETECT questionnaire survey before surgery. A score of 12 or lower was recorded as \'neuropathic component unlikely\', a score of 19 or higher as \'neuropathic pain likely\', and scores between 13 and 18 as \'neuropathic pain possible\'. LBP severity was recorded on a numerical rating scale, the Roland-Morris Disability Questionnaire, and the EuroQol-5 dimension-5 level.
RESULTS: The mean painDETECT score was 11.8 and did not significantly differ between the superior CN-E and middle CN-E groups. We classified low back pain as unlikely to have a neuropathic component in 13 patients, as likely to have a neuropathic component in 2 patients, and as possibly neuropathic in 4 patients. There was no significant difference in the pain level of patients with scores of ≤12 and ≥13 on painDETECT. All patients reported trigger pain; the positive rate was high for electric shock pain, radiating pain, and pain attacks and low for a burning or tingling sensation, pain elicited by a light touch, and pain caused by cold or hot stimulation.
CONCLUSIONS: The painDETECT questionnaire may not reliably identify LBP caused by superior/middle CN-E as neuropathic pain. A diagnosis of LBP due to CN-E must be made carefully because symptoms resemble nociceptive pain.
摘要：
背景：上/中肘部神经卡压（CN-E）是下腰痛（LBP）的诱发因素。疼痛检测问卷用于表征CN-E症状。
方法：由CN-E引起的LBP的19例连续患者（上CN-E=7；中CN-E=12）参加了手术前的日语疼痛DETECT问卷调查。12分或更低的分数被记录为“不太可能的神经病变成分”，19分或更高的“神经性疼痛可能”，得分在13到18之间，即“神经性疼痛可能”。LBP严重程度记录在数字评定量表上，罗兰-莫里斯残疾问卷，和EuroQol-5维度-5级别。
结果：平均疼痛检测评分为11.8分，在较高的CN-E组和中间的CN-E组之间没有显著差异。我们在13例患者中将下腰痛分类为不太可能有神经性成分，2名患者可能有神经病变成分，4名患者可能患有神经病。painDETECT评分≤12分和≥13分的患者疼痛水平无显著差异。所有患者均报告触发疼痛；电击疼痛阳性率高，放射疼痛，疼痛发作和低度的灼热或刺痛感，轻微的触摸引起的疼痛，和冷或热刺激引起的疼痛。
结论：痛苦检测问卷可能无法可靠地将由上/中CN-E引起的LBP确定为神经性疼痛。必须仔细诊断由于CN-E引起的LBP，因为症状类似于伤害性疼痛。
方法：由CN-E引起的LBP的19例连续患者（上CN-E=7；中CN-E=12）参加了手术前的日语疼痛DETECT问卷调查。12分或更低的分数被记录为“不太可能的神经病变成分”，19分或更高的“神经性疼痛可能”，得分在13到18之间，即“神经性疼痛可能”。LBP严重程度记录在数字评定量表上，罗兰-莫里斯残疾问卷，和EuroQol-5维度-5级别。
结果：平均疼痛检测评分为11.8分，在较高的CN-E组和中间的CN-E组之间没有显著差异。我们在13例患者中将下腰痛分类为不太可能有神经性成分，2名患者可能有神经病变成分，4名患者可能患有神经病。painDETECT评分≤12分和≥13分的患者疼痛水平无显著差异。所有患者均报告触发疼痛；电击疼痛阳性率高，放射疼痛，疼痛发作和低度的灼热或刺痛感，轻微的触摸引起的疼痛，和冷或热刺激引起的疼痛。
结论：痛苦检测问卷可能无法可靠地将由上/中CN-E引起的LBP确定为神经性疼痛。必须仔细诊断由于CN-E引起的LBP，因为症状类似于伤害性疼痛。
