Stelzer Wolfgang, Stelzer Valentin, Stelzer Dominik, Braune Monika, Duller Christine
Medizinisches Zentrum SchmerzLOS Linz and Baden/Vienna, Vienna.
Johannes Kepler University Linz, Linz, Austria.
J Pain Res. 2017 Jan 13;10:183-190. doi: 10.2147/JPR.S121897. eCollection 2017.
This retrospective original research was designed to illustrate the general outcome after radiofrequency (RF) neurotomy of lumbar medial branch (MB) and posterior ramus of the sacroiliac joint of 160 patients with chronic low back pain (LBP) 1, 6, and 12 months after treatment.
Visual Analog Scale (VAS) 0-10 pain scores, quality of life, body mass index (BMI), medication usage, and frequency of physical exercise/sports participation (none, 1-3×/week, more) were collected before the procedure, at 1 month post procedure (n=160), and again at 6 (n=73) and 12 months (n=89) post procedure.
A VAS decrease of 4 points on a 10-point scale (from 8 to 4) in the overall group was seen after 6 months and of 4.5 after 12 months. Lower medication usage was reported, with opioids decreased by 40% and nonsteroidal anti-inflammatory drugs (NSAIDs) by 60%. Decreased pain lasted for 12 months. Significantly better outcomes were reported by patients with BMIs <30. No gender-specific differences occurred in the reported decrease in VAS. Analysis of the "no-sports" group versus the more active (1-3 times weekly sports) group showed a better pain decrease after 1 year in the active group.
The data suggest RF treatment for chronic LBP that can lead to long-term improvement. Patients with a BMI >30 are less likely to report decreased pain. The better long-term pain relief in the sports participating group is a motivation for the authors to keep the patients in motion.
本回顾性原创研究旨在阐明160例慢性下腰痛(LBP)患者在接受腰椎内侧支(MB)和骶髂关节后支射频(RF)神经切断术治疗后1个月、6个月和12个月的总体疗效。
收集术前、术后1个月(n = 160)、术后6个月(n = 73)和术后12个月(n = 89)的视觉模拟量表(VAS)0 - 10分疼痛评分、生活质量、体重指数(BMI)、药物使用情况以及体育锻炼/运动参与频率(无、每周1 - 3次、更多)。
6个月后总体组VAS评分在10分制上下降了4分(从8分降至4分),12个月后下降了4.5分。报告的药物使用减少,阿片类药物减少了40%,非甾体抗炎药(NSAIDs)减少了60%。疼痛减轻持续了12个月。BMI < 30的患者报告的疗效明显更好。报告的VAS下降情况未出现性别差异。对“不运动”组与运动更频繁(每周进行1 - 3次运动)组的分析显示,1年后运动组疼痛减轻情况更好。
数据表明RF治疗慢性LBP可带来长期改善。BMI > 30的患者报告疼痛减轻的可能性较小。运动参与组更好的长期疼痛缓解情况促使作者鼓励患者保持运动。