gms | German Medical Science

Objective: Published studies reported a widely varying correlation among the most common pain scales, both at the level of test and comparison of pain with the functional state of the same patient. The visual analog scale (VAS) is one of the most used instruments to quantify patient’s pain. Beside the subjectivity of this test there is also a lack of information concerning the patient’s dysfunctionality. Although pain often limits physical activities of the patient, there is no instrument to investigate pain and the pain related physical impairment in daily routine. The aim of this study was to correlate the VAS with the “Timed up and go- test” and eventually point out a better description of pain and pain related physical impairment due to degenerative lumbar disease and operative treatment.

Method: We assessed 30 patients with degenerative lumbar diseases treated by mono- or bisegmental spondylodesis (conservative treatments failed). Patients were evaluated prior to surgery, first, third and sixth day postoperative followed by two, four and twelve weeks after surgery. Visual analog scale and “Timed up and go- test” were measured.

Results: Comparing the VAS of preoperative back pain to all postoperative follow-up visits there is a significant improvement of back pain on the 6 th postoperative day (p<0.001). In the same analyse the TuG shows a significant improvement at the 7^th follow-up visit (4 weeks postop, p<0.017) compared to preoperative TuG. Postoperatively, follow-up examinations were compared with each other chronologically (e.g. 1^st postop day with 3^th postoperative day, etc.). In this assessment the visual analog scale showed a significant improvement from day 1 to 3 and day 3 to 6 (p<0.024 and 0.012, respectively). However the TuG appeared to be more sensitive in the postoperative short follow-up with improvement of functional disability to walk in every timeline (1 day to 3 day, 3 day to 6 day, 6 day to 2 weeks and 2 weeks to 4 weeks) except from 4 weeks to 12 weeks postoperative. Overall we found no correlation between the two tests.

Conclusions: The following study represents differences comparing both tests. On the one hand the VAS simply describes pain without patient’s functional state, on the other hand the TuG describes functional disability without pain, although pain influences the patient’s functional state. In the future the need of both, information of pain and functional disability, will be required to evaluate a patient sufficiently due to degenerative spine diseases.