Một số yếu tố liên quan giữa đau do nguyên nhân thần kinh theo thang điểm DN4 với các đặc điểm lâm sàng và cận lâm sàng ở bệnh nhân thoái hóa cột sống thắt lưng

Abstract

A cross-sectional descriptive study conducted on 101 patients with lumbar spine osteoarthritis and pain (VAS ≥ 3) treated at the Rheumatology Center, Bach Mai Hospital, from August 2024 to August 2025 showed that the prevalence of neuropathic low back pain according to the DN4 scale was 34.7%. Factors significantly associated with neuropathic pain included advanced age (≥ 70 years old), overweight or obesity (BMI ≥ 23), severe pain intensity (VAS ≥ 7), and lumbar spine radiographic findings such as foraminal stenosis, intervertebral disc space narrowing, loss of physiological curvature, and involvement of four or more vertebral levels with osteophytes, with corresponding odds ratios of 2.52, 3.31, 18.39, 22.29, 3.78, 3.07, and 8.46, respectively. DN4 scores showed positive correlations with VAS pain scores and the number of vertebral levels with osteophytes. These findings indicate that neuropathic pain is common in patients with lumbar spine osteoarthritis, is associated with pain severity and radiographic structural changes, and therefore should be identified early to guide appropriate treatment strategies.