Fritsch Carolina G, Ferreira Manuela L, Maher Christopher G, Herbert Robert D, Pinto Rafael Z, Koes Bart, Ferreira Paulo H
Discipline of Physiotherapy, Faculty Health Sciences, The University of Sydney, Sydney, Australia.
Departamento de Fisioterapia, Universidade Federal de Ciências da Saúde de Porto Alegre, R. Sarmento Leite 245, Porto Alegre, Brazil.
Eur Spine J. 2017 Feb;26(2):324-335. doi: 10.1007/s00586-016-4668-0. Epub 2016 Jul 21.
The aim of this study was to assess the clinical course of pain and disability in patients with lumbar spinal stenosis following surgery.
Electronic databases were searched to July 2014 and only prospective cohort studies assessing pain or disability following surgery for lumbar spinal stenosis were included. Two independent reviewers extracted data and assessed study quality. Estimates of pain and disability (expressed as 0-100 point scales) as well as 95 % confidence intervals were obtained using meta-regression. The effect of time was clearly non-linear, so it was modelled using fractional polynomial regression.
From a total of 10,741 titles, 69 publications (64 cohort studies) were included in the review. Pooled estimate for pain pre-operatively was 63.4 (95 % CI 56.5; 70.3), reducing to 33.1 (95 % CI 24.2; 41.9) at 3 months and 19.2 points (95 % CI 9.2; 29.3) at 60 months. Pre-operative estimates of disability were 36.9 (95 % CI 32.6; 41.3), reducing to 16.3 (95 % CI 11.8; 20.9) at 3 months and 12.4 (95 % CI 7.7; 17.2) at 60 months.
Patients with lumbar spinal stenosis experience rapid symptom reduction after surgery, but should still expect to experience mild-to-moderate pain and disability 60 months later.
本研究旨在评估腰椎管狭窄症患者术后疼痛和残疾的临床病程。
检索电子数据库至2014年7月，仅纳入评估腰椎管狭窄症手术后疼痛或残疾的前瞻性队列研究。两名独立 reviewers 提取数据并评估研究质量。使用meta回归获得疼痛和残疾的估计值（以0 - 100分制表示）以及95%置信区间。时间的影响明显是非线性的，因此使用分数多项式回归进行建模。
在总共10741个标题中，该综述纳入了69篇出版物（64项队列研究）。术前疼痛的合并估计值为63.4（95%CI 56.5；70.3），3个月时降至33.1（95%CI 24.2；41.9），60个月时降至19.2分（95%CI 9.2；29.3）。术前残疾估计值为36.9（95%CI 32.6；41.3），3个月时降至16.3（95%CI 11.8；20.9），60个月时降至12.4（95%CI 7.7；17.2）。
腰椎管狭窄症患者术后症状迅速减轻，但60个月后仍可能经历轻至中度疼痛和残疾。
