Background Pain drawing (PD) is an important tool to assess patient’s pain. In the past few years, electronic PD has achieved rapid development. However, there is no research on the value of applying electronic PD in percutaneous endoscopic lumbar discectomy.
Objective To explore the value of 3D Pain Drawing System in evaluating the changes of pain degree in patients with low back pain caused by lumbar disc herniation treated by percutaneous endoscopic lumbar discectomy (PELD).
Methods From October 2019 to April 2020, 66 patients with lumbar disc herniation and low back pain symptoms were selected for unilateral percutaneous endoscopic lumbar discectomy in the First Medical Center of Chinese PLA General Hospital. All operations were performed under local anesthesia. For this research, the 3D Pain Drawing System were designed and developed to record pain distribution range and degree. The PD scores at preoperation, intraoperation and postoperative 3 months were described by pain mapping, pain visual analog scale (VAS) score and Oswestry disability index (ODI) score were recorded to observe the degree of pain and changes, so as to verify whether 3D pain drawing could accurately evaluate the degree and changes of low back pain in these patients.
Results The preoperative PD score was positively correlated with the preoperative ODI and VAS score (r=0.537, r=0.370; P＜0.01, respectively). During the operation, there were positive correlations between the pain PD scores and VAS scores in the four different anatomical sites (nucleus pulposus, annulus fibrosus, ligamentum flavum and posterior longitudinal ligament), and the correlation coefficients were 0.667, 0.740, 0.825, 0.684, respectively, with significant differences (all P＜0.01). The intraclass correlation coefficients of PD score improvement rate with ODI improvement rate (ICC=0.781, 95% CI: 0.644-0.870) and VAS score improvement rate (ICC=0.732, 95% CI: 0.571-0.839) in evaluating the treatment effect of low back pain showed high consistency. The PD score of low back pain was positively correlated with ODI and VAS scores at 3 months after operation (r=0.771, r=0.745; P＜0.01, respectively).
Conclusion The PD score shows highly consistency with other pain evaluation methods, and 3D pain drawing system is a good evaluation tool for the degree and change of low back pain in patients with lumbar disc herniation treated by PELD.
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