Christensen Tyler J, DeBerard M Scott, Wheeler Anthony J
Department of Psychology, Utah State University, Logan, UT, USA.
J Pain Res. 2017 May 19;10:1207-1215. doi: 10.2147/JPR.S132853. eCollection 2017.
The prevalence of radiofrequency zygapophyseal joint neurotomy (RFN) has increased substantially across the past decade. Limited research exists that has examined pre-procedure predictors of RFN outcomes, particularly within workers' compensation populations. The purpose of this study was to determine if pre-procedure biopsychosocial variables are predictive of outcomes in a cohort of compensated Utah patients who have undergone RFN.
This was a retrospective cohort study consisting of a review of pre-procedure medical records and a telephone outcome survey. The sample consisted of 101 compensated workers from Utah who had undergone RFN. Fifty-six patients (55%) responded to the outcome survey. Patients were an average of 46 months post-neurotomy at the time of follow-up. Outcome measures included patient satisfaction, disability status, Roland-Morris Disability Questionnaire, Stauffer-Coventry Index, and Short-Form Health Survey-36 (v.2). Statistical techniques utilized included frequencies, mean comparisons, and logistic and multiple regressions.
Forty percent of patients were totally disabled at the time of follow-up. Lawyer involvement, older age, and a positive history of depression were predictors of poor outcomes in logistic and multiple regression equations.
Presurgical biopsychosocial variables were predictive of multidimensional patient outcomes, and a high rate of total disability was observed. Additional research on the effectiveness of RFN for workers' compensation patients is recommended.
在过去十年中,射频关节突关节神经切断术(RFN)的应用率大幅上升。针对RFN手术预后的术前预测因素的研究有限,尤其是在工伤赔偿人群中。本研究的目的是确定术前生物心理社会变量是否可预测接受RFN手术的犹他州工伤赔偿患者队列的预后。
这是一项回顾性队列研究,包括术前病历审查和电话随访调查。样本包括101名来自犹他州接受过RFN手术的工伤赔偿工人。56名患者(55%)回复了随访调查。随访时患者平均在神经切断术后46个月。预后指标包括患者满意度、残疾状况、罗兰-莫里斯残疾问卷、斯托弗-考文垂指数和简短健康调查问卷-36(第2版)。所采用的统计技术包括频率分析、均值比较、逻辑回归和多元回归。
随访时40%的患者完全残疾。在逻辑回归和多元回归方程中,律师介入、年龄较大和有抑郁症病史是预后不良的预测因素。
术前生物心理社会变量可预测患者多维度预后,且观察到较高的完全残疾率。建议对RFN治疗工伤赔偿患者的有效性进行更多研究。