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Journal of Korean Neurosurgical Society 2007;41(1): 65-68. |
Neuropathic Back Pain : Are There Any Practical Diagnostic Criteria?. |
Kyeong Seok Lee, Jae Jun Shim, Jae Won Doh, Seok Mann Yoon, Hack Gun Bae, Il Gyu Yun |
Department of Neurosurgery, Soonchunhyang University Cheonan Hospital, Cheonan, Korea. ksleens@hotmail.com |
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ABSTRACT |
OBJECTIVE A new point of view on the chronic back pain proposed which is, named neuropathic back pain(NBP). Some proposed a certain pain scale as an useful diagnostic tool.
Before scientific verification, some doctors prescribed a new anticonvulsant for the NBP. We investigated diagnostic tools for NBP by a review of the literature. METHODS A comprehensive computer search of the English literature concerning neuropathic low back pain was performed using the key words such as neuropathic back pain and diagnosis in the PubMed. RESULTS In 1998, the term NBP was first used in a patient with lung cancer. In the English literature, there were two diagnostic methods for the NBP, Neuropathic pain scale(NPS) and a pharmacological test. NPS is a pain questionnaire, which depends on the patients'subjective reports on the given questions, such as 'how hot is your pain feel'. By the pharmacological test, NBP was defined as 50% or more decrease of pain on intravenous lidocaine and on local anesthetic epidurally. It also depends on the patients'subjective response to the therapy. CONCLUSION There were still no reliable objective diagnostic criteria for the NBP. It seems to be better to reserve the new anticonvulsants for the NBP till scientific approval. |
Key Words:
Back pain diagnosis; Pain measurement; Anticonvulsants |
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