Adaptación de la Escala de Evaluación Estandarizada del Dolor (StEP) en población mexicana con radiculopatía lumbar

Abstract

Introduction: The radicular pain is the result of compressive pathologies and/or not compressive conditions. Its nature is the guide in its assessment; the quality, intensity and location oriented etiology. The clinic is useful to associate symptoms and signs with the painful Phenotype and the underlying mechanism. The scale Standardized Evaluation of Pain (StEP) discriminate between radicular and axial low back pain through clinical evaluation of interrogation (3 questions) and physical examination (8 test) with 92% sensitivity and specificity of 97%. Objective: To adapt the scale StEP to the Spanish for the evaluation of patients with lumbar radiculopathy in Mexican population. Methodology: Design: adaptation of diagnostic scale. Stages: Selection of scale, the Spanish translation - re English translation, adjustment and utility items, Pilot test. Validity and reliability testing. Inclusion criteria: patients any gender, 18 years or older, chronic low back pain with or without radiation, signing of informed consent. Non inclusion criteria: Neuropathies, polineuropathies, myopathy, neurological disease, myofascial, venous, psychiatric or cardiovascular. Degenerative disease of spine or spine surgery. Sample size: 21 patients test pilot. Results: The scale was applied twice for each patient in two visits a week interval, 2 medical evaluators. Total: 21 patients, 9 female (42.9%), 12 male (57.1%). Age: 22 to 58 years (average 38). Initial diagnostic: low back pain 7(33.3%), lumbosciatica 6(28.6%), hernia discal 5(23.8%), spondylolisthesis 2(9.5%), radiculopathy 1 (4.8%). Evaluator 1: axial 18(85.7%), radicular 3 (14.3%). Evaluator 2: axial 14(66.7%), radicular 7(33.3%). Results of validity appropriate for it are application. Internal consistency (Cronbach alpha) 0.7. Test/retest time: 15 to 10 minutes. Inter-evaluator reliability (Kappa index) 0.5. Conclusion: The scale at this preliminary stage, presents great variability, it is not completely determinant in the identification and differentiation of radicular pain. It is necessary to conclude the validation in order to assess their diagnostic utility.