Department of Pain & Anaesthesia, James Cook University Hospital, Middlesbrough, Cleveland, UK; Department of Neurosurgery, Regina General Hospital, Regina, Saskatchewan, Canada; Neuromodulation Centre EHC Hospital, Morges, & Anaesthesia Service, CHUV, Lausanne, Vaud, Switzerland; and Peninsula Medical School, Universities of Exeter and Plymouth, Devon, UK.
Neuromodulation. 2010 Jul;13(3):201-9. doi: 10.1111/j.1525-1403.2009.00271.x. Epub 2010 Feb 22.
Failed back surgery syndrome (FBSS) patients experience pain, functional disability, and reduced health-related quality of life (HRQoL) despite anatomically successful surgery. Examining sub-dimensions of health outcomes measures provides insight into patient well-being.
The international multicenter PROCESS trial collected detailed HRQoL (EuroQol-5D; Short-Form 36) and function (Oswestry Disability Index) information on 100 FBSS patients.
At baseline, patients reported moderate-to-severe leg and back pain adversely affecting all dimensions of function and HRQoL. Compared with conventional medical management alone, patients also receiving spinal cord stimulation (SCS) reported superior pain relief, function, and HRQoL at six months on overall and most sub-component scores. The majority of these improvements with SCS were sustained at 24 months. Nonetheless, 36-40% of patients experienced ongoing marked disability (standing, lifting) and HRQoL problems (pain/discomfort).
Longer-term patient management and research must focus on these refractory FBSS patients with persisting poor function and HRQoL outcomes.
尽管手术在解剖学上取得了成功，但失败的腰椎术后综合征（FBSS）患者仍会经历疼痛、功能障碍和降低的健康相关生活质量（HRQoL）。检查健康结果测量的子维度可以深入了解患者的健康状况。
国际多中心 PROCESS 试验收集了 100 例 FBSS 患者的详细 HRQoL（EuroQol-5D；Short-Form 36）和功能（Oswestry 残疾指数）信息。
在基线时，患者报告中度至重度腿部和背部疼痛，对所有功能和 HRQoL 维度均有不利影响。与单独接受常规医疗管理的患者相比，还接受脊髓刺激（SCS）的患者在六个月时的疼痛缓解、功能和 HRQoL 总体和大多数子成分评分上均有更好的表现。SCS 的这些改善中的大多数在 24 个月时仍保持不变。尽管如此，仍有 36-40%的患者存在持续的显著残疾（站立、举重）和 HRQoL 问题（疼痛/不适）。
必须对这些存在持续不良功能和 HRQoL 结果的难治性 FBSS 患者进行长期的患者管理和研究。
