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工作相关的慢性下背痛——介入疼痛和脊柱诊所转诊后的重返工作岗位结果。

Work-related chronic low back pain-return-to-work outcomes after referral to interventional pain and spine clinics.

机构信息

Department of Environmental Medicine, University of Rochester Medical Center, Rochester, NY 14623, USA.

出版信息

Spine (Phila Pa 1976). 2012 Sep 15;37(20):E1282-9. doi: 10.1097/BRS.0b013e318265a930.

Abstract

STUDY DESIGN

A retrospective cohort study.

OBJECTIVE

To evaluate return-to-work outcomes in patients with chronic, work-related low back pain referred to pain treatment centers and/or spine clinics (PTCs/SCs).

SUMMARY OF BACKGROUND DATA

Return-to-work outcomes in cases of work-related chronic low back pain after referral to PTCs and/or SCs have not been previously studied.

METHODS

A retrospective chart review of 230 consecutive patients was conducted from an occupational medicine program. Of these, 122 patients were referred to a PTC/SC and 108 patients were not. Multivariate logistic regression was used to develop a model to predict improvement in functional status and pain level after 1 year.

RESULTS

At the 1-year evaluation, there was functional improvement in the nonreferral group (P < 0.001) and no change in the referral group (P = 0.21). The change in pain level was similar. Time from injury to initial evaluation seemed to be the major factor contributing to poor outcomes in both groups.

CONCLUSION

Referral to a PTC/SC did not yield improved functional outcomes in this cohort. A major factor contributing to this finding was the length of time to referral to PTC/SC after the initial injury.

摘要

研究设计

回顾性队列研究。

目的

评估慢性、与工作相关的下腰痛患者在转诊至疼痛治疗中心和/或脊柱诊所(PTC/SC)后的工作恢复情况。

背景资料概要

之前尚未研究过 PTC/SC 转诊后与工作相关的慢性下腰痛患者的工作恢复情况。

方法

对来自职业医学项目的 230 例连续患者进行了回顾性图表审查。其中,122 例患者转诊至 PTC/SC,108 例患者未转诊。采用多变量逻辑回归建立模型,以预测 1 年后功能状态和疼痛水平的改善情况。

结果

在 1 年评估时,非转诊组的功能有改善(P<0.001),而转诊组没有变化(P=0.21)。疼痛水平的变化也相似。两组的不良结局都与受伤后首次评估到接受 PTC/SC 治疗的时间间隔较长有关。

结论

在本队列中,转诊至 PTC/SC 并未改善功能结果。造成这种结果的一个主要因素是从初始损伤到接受 PTC/SC 治疗的时间间隔较长。

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