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犹他州工人赔偿患者中射频关节突关节神经切断术的结果及预后变量

Outcomes and prognostic variables of radiofrequency zygapophyseal joint neurotomy in Utah workers' compensation patients.

作者信息

Christensen Tyler J, DeBerard M Scott, Wheeler Anthony J

机构信息

Department of Psychology, Utah State University, Logan, UT, USA.

出版信息

J Pain Res. 2017 May 19;10:1207-1215. doi: 10.2147/JPR.S132853. eCollection 2017.

Abstract

PURPOSE

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.

PATIENTS AND METHODS

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.

RESULTS

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.

CONCLUSION

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.

摘要

目的

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。

患者与方法

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。

结果

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。

结论

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。

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