Higuchi Daisuke
Department of Physical Therapy, Faculty of Health Care, Takasaki University of Health and Welfare, Takasaki, Japan. ; Department of Rehabilitation, Harunaso Hospital, Takasaki, Japan.
Asian Spine J. 2015 Oct;9(5):675-82. doi: 10.4184/asj.2015.9.5.675. Epub 2015 Sep 22.
Single-center retrospective cohort study.
To clarify the prognostic value of preoperative coping strategies for pain due to compressive cervical myelopathy.
Preoperative physical function, imaging and electrophysiological findings are known predictors of surgical outcomes. However, coping strategies for pain have not been considered.
Postoperative questionnaires, concerning health-related quality of life (HRQOL) and daily living activities, were sent to 78 patients with compressive cervical myelopathy who had suffered from neuropathic pain before laminoplasty, and been preoperatively assessed with respect to their physical and mental status and coping strategies for pain. Hierarchical multiple regression analysis was performed to clarify the extent to which the patient's preoperative coping strategies could explain the variance in postoperative HRQOL and activity levels.
Forty-two patients with residual neuropathic pain after laminoplasty were analyzed by questionnaires (28 men, 14 women; mean age, 62.7±10.2 years; symptom duration, 48.0±66.0 months). The valid response rate was 53.8%. Hierarchical multiple regression analysis showed that preoperative coping strategies, which involved coping self-statements, diverting attention, and catastrophizing, were independently associated with postoperative HRQOL and activity level, and could explain 7% to 11% of their variance. Combinations of the coping strategies for pain and upper/lower motor functions could explain 26% to 36% of the variance in postoperative HRQOL and activity level.
Preoperative coping strategies for pain are good predictors of postoperative HRQOL and activities of daily living in patients with postoperative residual neuropathic pain due to compressive cervical myelopathy.
单中心回顾性队列研究。
阐明术前应对策略对压迫性颈椎病所致疼痛的预后价值。
术前身体功能、影像学和电生理检查结果是已知的手术结果预测指标。然而，尚未考虑疼痛的应对策略。
向78例压迫性颈椎病患者发送了关于健康相关生活质量（HRQOL）和日常生活活动的术后问卷，这些患者在椎板成形术前患有神经性疼痛，并在术前对其身心状况和疼痛应对策略进行了评估。进行分层多元回归分析，以阐明患者术前应对策略能够解释术后HRQOL和活动水平差异的程度。
通过问卷对42例椎板成形术后仍有神经性疼痛的患者进行了分析（28例男性，14例女性；平均年龄62.7±10.2岁；症状持续时间48.0±66.0个月）。有效回复率为53.8%。分层多元回归分析表明，术前应对策略，包括应对自我陈述、转移注意力和灾难化思维，与术后HRQOL和活动水平独立相关，并能解释其7%至11%的差异。疼痛应对策略与上下运动功能的组合可解释术后HRQOL和活动水平差异的26%至36%。
术前疼痛应对策略是压迫性颈椎病术后残留神经性疼痛患者术后HRQOL和日常生活活动的良好预测指标。
