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定量感觉测试在脊柱研究中的价值。

The value of quantitative sensory testing in spine research.

作者信息

Tschugg Anja, Löscher Wolfgang N, Lener Sara, Hartmann Sebastian, Wildauer Matthias, Neururer Sabrina, Thomé Claudius

机构信息

Department of Neurosurgery, Medical University Innsbruck, Anichstr. 35, A-6020, Innsbruck, Austria.

Department of Neurology, Medical University Innsbruck, Innsbruck, Austria.

出版信息

Neurosurg Rev. 2017 Jul;40(3):411-418. doi: 10.1007/s10143-016-0798-4. Epub 2016 Nov 28.

Abstract

The improvement of pain and functionality is the major goal of a surgical intervention. Thus, the purpose of the present prospective study was to evaluate whether subjective sensory deficits in patients with lumbar radiculopathy caused by a lumbar disc herniation are related to clinical status, using several outcome scores and the quantitative sensory testing (QST) pre- and 12 months postoperatively. We applied the QST in 52 patients with a single lumbar disc herniation treated by lumbar sequestrectomy pre- and 12 months postoperatively. Further evaluation included numeric rating scale (NRS) for leg, EuroQoL-5D (EQ-5D), Core Outcome Measure Index (COMI), Oswestry Disability Index (ODI), Beck Depression Inventory (BDI) and PaindDetect questionnaire (PD-Q). Patients were then categorized into two groups based on their subjective recovery of sensory function. The patients' self-assessment and QST were correlated with each other for the pre- and postoperative visit after 12 months. The two groups showed postoperative differences in mechanical and vibration detection threshold as well as in the postoperative PD-Q (p < 0.005). Multidimensional scores did not consistently match the QST parameters in patients with a lumbar disc herniation. Commonly used clinical scores in spine research show low or no correlation with QST. Nevertheless, mechanical thresholds seem to play an important role to detect and follow up a sensory deficit investigated by QST.

摘要

疼痛和功能的改善是外科手术干预的主要目标。因此,本前瞻性研究的目的是,通过术前及术后12个月使用多种疗效评分和定量感觉测试(QST),评估腰椎间盘突出症所致腰椎神经根病患者的主观感觉缺陷是否与临床状态相关。我们对52例行腰椎间盘摘除术的单节段腰椎间盘突出症患者在术前及术后12个月应用了QST。进一步评估包括腿部数字评定量表(NRS)、欧洲五维健康量表(EQ-5D)、核心结局指标指数(COMI)、Oswestry功能障碍指数(ODI)、贝克抑郁量表(BDI)和疼痛检测问卷(PD-Q)。然后根据患者感觉功能的主观恢复情况将其分为两组。在术后12个月的术前和术后访视中,患者的自我评估与QST相互关联。两组在机械感觉和振动检测阈值以及术后PD-Q方面存在差异(p<0.005)。腰椎间盘突出症患者的多维评分与QST参数并不总是一致。脊柱研究中常用的临床评分与QST的相关性较低或无相关性。尽管如此,机械阈值似乎在检测和随访QST所研究的感觉缺陷方面起着重要作用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/812d/5486464/e0def901bfb2/10143_2016_798_Fig1_HTML.jpg

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