Checchia G A, Letizia Mauro G, Morico G, Oriente A, Lisi C, Polimeni V, Lucia M, Ranieri M
Physical Medicine and Rehabilitation Unit, Santa Corona Hospital, ASL2 Savonese, Savona, Italy.
Eur Rev Med Pharmacol Sci. 2017 Apr;21(7):1653-1664.
To provide information on the clinical presentation of sciatic neuropathy and its management in a real-world setting, and to analyze the effects of a multimodal approach based on the association of physical and pharmacological therapy.
A multicentric observational prospective study was conducted in 44 Italian tertiary centers specialized in Physical Medicine and Rehabilitation, Orthopedics, Neurology, Neurosurgery, and Rheumatology. To develop a shared management of LPB with sciatica, a dedicated clinical record was proposed to collect data about diagnosis, treatment, and outcomes. Pain, disability, and quality of life were recorded trough validated questionnaires at baseline and after a two-month follow-up.
394 patients (age, mean ± SD 55.7 ± 14.1 years, 57.1% females) with chronic LBP and sciatica were enrolled in the study. The characteristics of the selected group showed a certain variability in the clinical presentation. At baseline, patients received several different therapeutic options among physical, pharmacological and neurotrophic treatments. A subgroup of 312 patients was treated with a combination of neurotrophic agents containing alpha-lipoic acid (ALA). After a two-month follow-up, a general improvement in both perceived pain and functional disabilities was observed. A significant improvement (p < 0.001) in the Pain Numeric Rating Scale (NRS), Roland e Morris Disability Questionnaire (RMDQ) and Brief Pain Inventory (BPI) Italian short version was observed.
Sciatic neuropathy is a multifaceted condition managed by means of a wide spectrum of therapeutic options. The results of this study suggest that a multimodal approach based on the association of ALA with physical and pharmacological therapies can be beneficial in the treatment of LBP with sciatica.
提供坐骨神经病变在现实环境中的临床表现及其管理方面的信息，并分析基于物理治疗与药物治疗联合的多模式方法的效果。
在意大利44个专门从事物理医学与康复、骨科、神经科、神经外科和风湿病学的三级中心进行了一项多中心观察性前瞻性研究。为制定伴有坐骨神经痛的腰丛病变的共同管理方案，提出了一份专门的临床记录，以收集有关诊断、治疗和结果的数据。在基线和两个月随访后，通过经过验证的问卷记录疼痛、残疾和生活质量。
394例慢性腰痛和坐骨神经痛患者（年龄，平均±标准差55.7±14.1岁，57.1%为女性）纳入研究。所选组的特征在临床表现上存在一定差异。基线时，患者在物理、药物和神经营养治疗中接受了几种不同的治疗选择。312例患者的亚组接受了含α-硫辛酸（ALA）的神经营养药物联合治疗。经过两个月的随访，观察到疼痛和功能残疾均有总体改善。疼痛数字评定量表（NRS）、罗兰·莫里斯残疾问卷（RMDQ）和简明疼痛量表（BPI）意大利语简版有显著改善（p<0.001）。
坐骨神经病变是一种需通过多种治疗选择来管理的多方面病症。本研究结果表明，基于ALA与物理和药物治疗联合的多模式方法在治疗伴有坐骨神经痛的腰痛方面可能有益。
