Comprehensive assessment of quality of life in patients with vertebrogenic lumbosacral radiculopathy

Vertebrogenic lumbosacral radiculopathy is one of the leading causes of chronic pain syndrome and temporary disability in people of working age. A comprehensive approach to assessing quality of life using validated scales allows you to personalize therapeutic tactics and increase the effectiveness of rehabilitation. Objective - to analyze the effect of the neuropathic component of chronic pain syndrome vertebrogenic lumbosacral radiculopathy on various aspects of the quality of life of patients. Material and methods. The cohort study included 60 patients (32 male, 28 female; mean age 47,3±9,8 years) with MRI-verified L4-S1 root compression. All patients were evaluated for the intensity of pain syndrome on a visual analogue scale, functional insufficiency on the Oswestry questionnaire, and the presence of a neuropathic component on the DN4 scale. Statistical analysis was performed using Spearman's test and Mann-Whitney U test. Results. The mean pain score on the visual analogue scale was 6.4±1.8 points (severe pain). The average Oswestry disability index is 47.2±14.3%, which corresponds to a severe degree of functional impairment. The most affected areas were weight lifting, prolonged standing, pain intensity, sleep and social activity. The neuropathic component of pain (DN4 ≥ 4) was detected in 48 patients (80,0%). There was a strong positive association between the presence of the neuropathic component and the degree of functional impairment (r=0,72; p<0.01). Patients with neuropathic pain had significantly higher disability scores according to the Oswestry questionnaire (54.1% versus 35.6% in the group without neuropathy, p<0.001). Conclusion. A comprehensive assessment of quality of life using a visual analogue scale and the Oswestry and DN4 questionnaires allows not only to quantify the intensity of pain and the degree of vital activity limitation, but also to identify a clinically significant neuropathic phenotype associated with a more severe course of the disease. The identification of neuropathic pain in 80.0% of patients justifies the need for routine screening using the DN4 scale and the inclusion of drugs in the therapeutic strategy to improve quality of life.

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