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对于以腿部疼痛为主且下背部疼痛水平升高的患者,腰椎间盘切除术后使用Oxiplex凝胶减轻腿部疼痛:一项前瞻性、随机、双盲、多中心临床研究。

Reduction of Leg Pain by Oxiplex Gel After Lumbar Discectomy in Patients With Predominant Leg Pain and Elevated Levels of Lower Back Pain: A Prospective, Randomized, Blinded, Multicenter Clinical Study.

作者信息

Lei Wei, Ehmsen Ronald J, Chiacchierini Richard P, Krelle John L, diZerega Gere S

机构信息

*Institute of Orthopaedics, Xijing Hospital, The Fourth Military Medical University, Xi'an, Shanxi, People's Republic of China †FzioMed Inc., San Luis Obispo, CA ‡R.P. Chiacchierini & Associates, LLC, Rockville, MD §Livingston Research Laboratory, University of Southern California, Los Angeles, CA.

出版信息

J Spinal Disord Tech. 2015 Oct;28(8):301-7. doi: 10.1097/BSD.0b013e3182a35590.

Abstract

STUDY DESIGN

A prospective, randomized, blinded, multicenter clinical study.

OBJECTIVE

To evaluate carboxymethylcellulose/polyethylene oxide gel (Oxiplex) in improving clinical outcomes in subjects having predominant leg pain and elevated low back pain undergoing first-time lumbar discectomy for disk herniation.

SUMMARY OF BACKGROUND DATA

Clinical studies in the United States and Italy found that Oxiplex reduced leg pain after decompression surgery.

METHODS

A total of 68 subjects with herniated lumbar disk were enrolled and randomized into treatment (surgery plus gel) or surgery-only control groups. A prospective statistical analysis assessed the effect of gel in the severe back pain subgroup (prespecified as greater than or equal to median baseline back pain of the population studied). All subjects except 2 controls lost to follow-up completed the study. Preoperative and postoperative visual analogue scale leg pain scores were analyzed and compared between groups at 60 days after surgery.

RESULTS

There were no serious adverse events or neurological safety concerns reported in any patients. Gel-treated patients had statistically significantly lower visual analogue scale leg pain scores at study end compared with controls (P=0.0240), representing a 21% additional reduction in leg pain compared with surgery alone in the severe baseline back pain subgroup (P=0.0240). The proportion of subgroup patients experiencing zero leg pain at study end was significantly higher in the gel treatment group (60%) than in the control group (23%) (P=0.0411).

CONCLUSIONS

The data from this study confirm and extend results of 2 previous studies in Italy and the United States that reported statistically significantly greater reductions in leg pain in gel-treated patients with severe preoperative low back pain compared with patients who only underwent decompression surgery.

摘要

研究设计

一项前瞻性、随机、双盲、多中心临床研究。

目的

评估羧甲基纤维素/聚环氧乙烷凝胶(Oxiplex)对首次因椎间盘突出症接受腰椎间盘切除术且以腿部疼痛为主并伴有下腰痛加重的患者临床疗效的改善情况。

背景数据总结

美国和意大利的临床研究发现,Oxiplex可减轻减压手术后的腿部疼痛。

方法

共纳入68例腰椎间盘突出症患者,随机分为治疗组(手术加凝胶)和单纯手术对照组。一项前瞻性统计分析评估了凝胶在严重背痛亚组(预先设定为大于或等于所研究人群基线背痛中位数)中的效果。除2例失访的对照组患者外,所有受试者均完成了研究。分析并比较了术前和术后60天两组间的视觉模拟量表腿部疼痛评分。

结果

所有患者均未报告严重不良事件或神经安全性问题。与对照组相比,凝胶治疗组患者在研究结束时视觉模拟量表腿部疼痛评分在统计学上显著更低(P = 0.0240),在严重基线背痛亚组中,与单纯手术相比,腿部疼痛额外减轻了21%(P = 0.0240)。在研究结束时腿部疼痛为零的亚组患者比例,凝胶治疗组(60%)显著高于对照组(23%)(P = 0.0411)。

结论

本研究数据证实并扩展了之前意大利和美国的两项研究结果,即与仅接受减压手术的患者相比,术前有严重下腰痛的凝胶治疗患者腿部疼痛在统计学上显著减轻更多。

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