Neuropathic Pain Was Associated with Central Sensitivity Syndrome in Patients with Preoperative Lumbar Spinal Stenosis Using the painDETECT and Central Sensitization Inventory Questionnaires: A Cross-Sectional Study.

Background: Lumbar spinal stenosis (LSS) patients have been reported to have neuropathic pain and central sensitivity syndrome (CSS). These associations have been reported in other diseases but are unknown in preoperative LSS patients. We aimed to investigate the association between neuropathic pain and CSS in preoperative LSS patients using the painDETECT and the Central Sensitization Inventory (CSI) questionnaires. Methods: This cross-sectional study was conducted from November 2021 to March 2022. The data were collected regarding demographics and pain, including neuropathic pain, numbness, LSS severity, physical function, quality of life, and CSS. Patients were divided into two groups, patients with acute and chronic pain, and further classified into three categories based on the clinical phenotype of patients in each group. Independent variables included age, gender, type of LSS (bilateral or unilateral symptoms), Numerical Rating Scale of leg pain, CSI, and the Zurich Claudication Questionnaire (ZCQ) for symptom severity and physical function. The dependent variable was painDETECT. Multiple regression analysis using the forced entry method examined the association between painDETECT and CSI. Results: Of the 119 patients with preoperative LSS, 106 were included. The mean age of the participants was 69.9 years, and 45.3% were female. Neuropathic pain was present in 19.8%, and CSS was present in 10.4%. The CSI (ß = 0.468, p < 0.001) and ZCQ for symptom severity (ß = 0.304, p < 0.01) were significantly associated with the painDETECT, explaining 47.8% of the variance in the painDETECT score. Conclusions: There is an association between neuropathic pain and CSS in patients with preoperative LSS using the painDETECT and CSI questionnaires.

A Case Report of Possible Thoracic Interdural Ganglion Cyst.

There are some intraspinal cystic lesions presenting with myelopathy. We report a case of myelopathy caused by a possible thoracic interdural ganglion cyst. A 70-year-old man with subacute bilateral lower extremity numbness, muscle weakness, and gait disturbance presented to our hospital. Magnetic resonance (MR) images showed a cystic lesion which compresses the left dorsolateral intraspinal space of T2-3. During surgery, a ganglion cyst was found without adhering to the periphery of the epidural space. The capsule and contents were removed. He showed postoperative improvement in activities of daily living. A postoperative pathological diagnosis of ganglion cyst was made. The development mechanism of thoracic interdural ganglion cysts is unknown. To our knowledge, this is the first report of this disease. Surgery improved symptoms of a patient with myelopathy caused by thoracic interdural ganglion cysts. This must be considered as one of the cystic lesions presenting with myelopathy.