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腰椎椎间孔狭窄症手术与抑郁的结局。

Outcome of lumbar intervertebral foraminal stenosis surgery and depression.

机构信息

Second University of Naples, Naples, Italy.

出版信息

Eur Neurol. 2013;69(5):304-8. doi: 10.1159/000346216. Epub 2013 Mar 6.

Abstract

A total of 58 patients consecutively underwent surgical treatment for lumbar intervertebral foraminal stenosis. We performed a microsurgical combined transarticular lateral and medial procedure with partial facetectomy in all patients to decompress the affected nerve root. All patients underwent assessment of depressive symptoms by means of the Zung Self Depression Scale (SDS). Subjective pain was self-evaluated by the Visual Analogue Scale (VAS). Both the tools were administered preoperatively, at 3 and 12 months' follow-up 0. The difference between the three SDS scores was significant (Friedman ANOVA, χ(2) = 53.171, p < 0.00001). The Wilcoxon rank test showed significant difference between preoperative SDS scores as compared with three months follow-up (Z = -6.393, p < 0.0001) and the last, in turn, as compared with twelve months follow- up (Z = -3.720, p = 0.0002). The comparison between preoperative and 12 months' follow-up also reached significance (Z = -3.285, p = 0.001). About VAS, the difference between the three VAS scores was significant (Friedman ANOVA, χ(2) = 69.932, p < 0.00001). The Wilcoxon rank test showed significant difference between preoperative VAS scores as compared with 3 months' follow-up (Z = -6.567, p < 0.0001) and the last, in turn, as compared with 12 months' follow-up (Z = -3.153, p < 0.002). The comparison between preoperative and 12 months' follow-up was also significance (Z = -5.520, p < 0.0001). Our results would alert clinicians to accurately consider the real need to treat and to include a careful psychiatric and psychological evaluation of these patients in the diagnosis and follow-up 0.

摘要

共有 58 例腰椎侧隐窝狭窄症患者连续接受手术治疗。我们对所有患者均采用经皮关节突关节外侧和内侧联合部分关节突切除术进行显微手术减压受累神经根。所有患者均采用zung 自评抑郁量表(SDS)评估抑郁症状。主观疼痛通过视觉模拟量表(VAS)自评。两种工具均在术前、术后 3 个月和 12 个月进行评估。三组 SDS 评分的差异有统计学意义(Friedman ANOVA, χ(2) = 53.171,p < 0.00001)。Wilcoxon 秩和检验显示,术前 SDS 评分与术后 3 个月(Z = -6.393,p < 0.0001)和最后一次评分(Z = -3.720,p = 0.0002)之间差异均有统计学意义。术前与术后 12 个月的比较也有统计学意义(Z = -3.285,p = 0.001)。关于 VAS,三组 VAS 评分的差异有统计学意义(Friedman ANOVA, χ(2) = 69.932,p < 0.00001)。Wilcoxon 秩和检验显示,术前 VAS 评分与术后 3 个月(Z = -6.567,p < 0.0001)和最后一次评分(Z = -3.153,p < 0.002)之间差异均有统计学意义。术前与术后 12 个月的比较也有统计学意义(Z = -5.520,p < 0.0001)。我们的结果提醒临床医生准确考虑治疗的实际需要,并在诊断和随访中包括对这些患者进行仔细的精神和心理评估。

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