The prevalence of neuropathic pain after non-traumatic spinal cord lesion

Werhagen, Lars; Hultling, Claes; Molander, Carl

doi:10.1038/sj.sc.3102000

Cited by 38 publications

(44 citation statements)

References 22 publications

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“…Siddall and Loeser found a prevalence of 65% 6 . However, in a study specifically on neuropathic pain, Werhagen et al 18 found a prevalence of 26% in a group of 402 patients with traumatic lesion in Switzerland, which corroborates our study 17 . They also did not find any correlation between occurrences of pain and patients' ages and level and type of lesion (complete or incomplete).…”

Section: Discussionsupporting

confidence: 82%

Neuropathic pain characteristics in patients from Curitiba (Brazil) with spinal cord injury

Vall

Costa

Santos

et al. 2011

Arq. Neuro-Psiquiatr.

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This was a descriptive cross-sectional study on patients with spinal cord injuries living in Curitiba, Paraná, Brazil. The aim was to evaluate the pain characteristics among such patients seen at referral care centers for spinal cord injury patients in Curitiba. A total of 109 adults with spinal cord injury in this city were evaluated regarding the presence of pain, especially neuropathic pain. Neuropathic pain was evaluated using the DN4 questionnaire, a universal instrument that has been translated and validated for Portuguese. A visual analog scale (VAS) was used to evaluate the intensity of pain. The prevalence of pain among these 109 patients was 31.2% (34 patients). The nociceptive pain presented was classified as musculoskeletal pain (nine patients), visceral pain (four patients) and mixed pain (one patient), thus totaling 14 patients (12.8%). Another 20 patients (18.3%) showed symptoms of neuropathic pain and fulfilled the criteria for neuropathic pain with scores greater than 4 out 10 in the DN4 questionnaire. Regarding the characteristics of the patients with neuropathic pain, most of them were male, younger than 40 years of age and paraplegic with incomplete lesions. They had become injured from 1 to more than 5 years earlier.The predominant etiology was gunshot wounds, and the intensity of their pain was high, with VAS scores greater than 5. This study partially corroborates other studies conducted on this subject. Studies of this type are important for understanding the profile of these patients, for the purpose of designing strategies for their rehabilitation, with a focus on the appropriate treatment and management of pain. Key words: neuropathic pain, spinal cord injury, DN4 questionnaire. Dor neuropática em pessoas com lesão medular residentes em Curitiba (Brasil) RESUMO Estudo transversal descritivo em pacientes com lesão medular que residem em Curitiba, Paraná, Brasil. O objetivo foi avaliar as características da dor em pacientes com lesão medular acompanhados em Centros de Reabilitação de referência na cidade. Os sujeitos envolvidos na pesquisa foram 109 pacientes adultos com lesão medular. Foi avaliada a presença de dor, principalmente dor neuropática, mediante aplicação do Questionário DN4, um instrumento universal traduzido e validado para o português. A Escala Visual Analógica (EVA) também foi usada para avaliar a intensidade da dor. A prevalência de dor nos 109 pacientes avaliados foi de 31,2%, ou seja, 34 pacientes. Destes, nove apresentaram dor nociceptiva classificada como músculo-esquelética, quatro dor visceral e um paciente apresentou dor mista, totalizando 14 pacientes (12,8%). Além disso, 20 pacientes (18,3%) apresentaram dor neuropática, cumprindo os critérios para este tipo de dor com uma contagem superior a 4/10 para o DN4. Sobre as características dos pacientes com dor neuropática, a maioria era do sexo masculino, abaixo de 40 anos, paraplégico com lesão incompleta e tempo de evolução entre um e cinco anos de lesão. A etiologia Correspondence Janaína Vall

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Section: Discussionsupporting

confidence: 82%

Neuropathic pain characteristics in patients from Curitiba (Brazil) with spinal cord injury

Vall

Costa

Santos

et al. 2011

Arq. Neuro-Psiquiatr.

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“…One of the most important secondary complications of SCI that negatively affects patient quality of life is neuropathic pain. 9 Werhagen et al 14 reported that SCI patients aged 450 years had the highest prevalence of neuropathic pain (58%). In the present study, 50.7% of the older patients and 34.7% of the younger patients reported neuropathic pain.…”

Section: Discussionmentioning

confidence: 99%

“…Logistic regression analysis in the present study showed that age X60 years was a significant risk factor for neuropathic pain, but that the level of injury, completeness of injury, gender and diabetes were not, as previously reported. 9,14 We think additional research on the factors that predispose older SCI patients to neuropathic pain is necessary.…”

Section: Discussionmentioning

confidence: 99%

Spinal cord injury in older population in Turkey

et al. 2014

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Study design: Retrospective, comparative 4-year study. Objectives: To identify the clinical characteristics unique to older patients with spinal cord injury (SCI). Setting: Turkish Armed Forces Rehabilitation Center, Ankara, Turkey. Methods: The study included 870 consecutive patients with SCI that were divided into two groups according to age. Patients aged X60 years at the time of injury constituted the study group, and randomly selected patients aged o60 years that were matched for gender, week of admission and time since injury constituted the control group. Patients' demographic and clinical characteristics were recorded, compared and analyzed. Results: The study group included 73 SCI patients (mean age: 66.98 ± 6.28 years) and the control group included 75 SCI patients (mean age: 33.93±10.67 years). Among the 148 patients, 98 (66.2%) were male. The vast majority of lesions were at the thoracic level (47.3%). In the older group, falls were the most frequent etiology (32.9%), simple falls predominated (62.5%). 49.3% of the study group vs 18.6% of the control group had a non-traumatic cause of SCI. Older patients were found to be less likely to have complete injury (27.4 vs 44%, P ¼ 0.035). The most common bladder management method was intermittent catheterization (69.6%) and the number of patients in each group treated with this method did not differ significantly (P40.05). More patients in the study group had neuropathic pain (50.7 vs 34.7%, P ¼ 0.049) and abnormal urinary ultrasound findings (23.3 vs 9.3%, P ¼ 0.021). Conclusion: Results revealed that older patients with SCI may have different demographic and clinical features compared with younger patients.

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“…Our prevalence of 52% is lower when compared with other reports in the SCI literature. 22,25 Prospective information to characterise the study population further, such as with the use of formal psychological and pain assessments, would add weight to our findings. Future prospective studies may examine this.…”

Section: Discussionmentioning

confidence: 99%

Retrospective study of rehabilitation outcomes following spinal cord injury due to tumour

Tan

New

2011

Spinal Cord

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Study design: Retrospective study. Objectives: To examine the rehabilitation outcomes for patients with spinal cord injury (SCI) due to tumour, with a focus on the impact of pain on disability and length of stay (LOS). Setting: Public hospital inpatient spinal rehabilitation unit, Melbourne, Australia.Methods: Retrospective open-cohort case series of consecutive patients admitted between 1/7/1996 and 30/6/2008 with a diagnosis of recent onset tumour causing SCI. Results: In all 108 patients were admitted, of whom 62% (n¼67) were male. The median age was 61.5 years (interquartile range (IQR) 53.6-74). Most patients had paraplegia (n¼97, 89.8%) and a metastatic tumour (n¼71, 65.7%) causing their SCI. For patients with a primary tumour the Rasch motor functional independence measure (FIM) gain between admission and discharge (median 17, IQR 4-23) was significantly greater (P¼0.006) than for those with secondary tumour (median 7, IQR from À4 to 15). Pain was present in 52% of patients and had a significant adverse influence on the rehabilitation process, with FIM motor efficiencies of 0.09 in patients with documented pain compared with 0.39 in patients without pain (P¼0.01). Patients with pain had significantly prolonged median LOS of 56 days (IQR 32.5-84.5) compared with 42 days (IQR 20.5-72.5, P¼0.03) without pain. Conclusion: Patients with SCI due to tumour have the potential to benefit from a focused, specialised SCI rehabilitation programme to optimise their outcomes. Careful patient selection, modifying the focus of team goals and a close relationship with treating oncologists and palliative care teams is essential.

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The prevalence of neuropathic pain after non-traumatic spinal cord lesion

Cited by 38 publications

References 22 publications

Neuropathic pain characteristics in patients from Curitiba (Brazil) with spinal cord injury

Neuropathic pain characteristics in patients from Curitiba (Brazil) with spinal cord injury

Spinal cord injury in older population in Turkey

Retrospective study of rehabilitation outcomes following spinal cord injury due to tumour

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