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慢性腰骶部神经根性疼痛患者脉冲射频治疗镇痛效果的预测因素:一项回顾性观察研究。

Predictors of the analgesic efficacy of pulsed radiofrequency treatment in patients with chronic lumbosacral radicular pain: a retrospective observational study.

作者信息

Kim Seon Ju, Park Sang Jun, Yoon Duck Mi, Yoon Kyung Bong, Kim Shin Hyung

机构信息

Department of Anesthesiology and Pain Medicine, Anesthesia and Pain Research Institute, Yonsei University College of Medicine, Seoul, Republic of Korea,

出版信息

J Pain Res. 2018 Jun 26;11:1223-1230. doi: 10.2147/JPR.S164414. eCollection 2018.

Abstract

BACKGROUND

Pulsed radiofrequency (RF) targeting the adjacent dorsal root ganglion (DRG) is one treatment option for lumbosacral radicular pain. However, the analgesic efficacy of this procedure is not always guaranteed. The aim of this retrospective study was to identify the predictors of the analgesic efficacy of pulsed DRG RF treatment in patients with chronic lumbosacral radicular pain.

METHODS

Patients who underwent pulsed DRG RF treatment from 2006 to 2017 at our clinic were enrolled. Positive response was defined as a ≥50% reduction in pain score from baseline at day 30. Patient demographics, pain-related factors, and clinical factors were evaluated using logistic regression analysis to identify the predictors of a positive response to the treatment.

RESULTS

A total of 60 patients satisfied the study protocol requirements. Twenty-eight patients (46.7%) had a positive outcome. Multivariate logistic regression analysis revealed that the absence of comorbid musculoskeletal pain (OR=0.518, 95% CI=0.029-0.858, =0.033) and positive response to previous epidural steroid injection (OR=3.269, 95% CI=1.046-10.215, =0.042) were independent predictors of the analgesic efficacy of pulsed DRG RF treatment.

CONCLUSION

Comorbid musculoskeletal pain and previous epidural injection response appear to affect the outcome of pulsed DRG RF treatment in patients with chronic lumbosacral radicular pain.

摘要

背景

针对相邻背根神经节(DRG)的脉冲射频(RF)是治疗腰骶神经根性疼痛的一种选择。然而,该手术的镇痛效果并非总能得到保证。这项回顾性研究的目的是确定慢性腰骶神经根性疼痛患者脉冲DRG射频治疗镇痛效果的预测因素。

方法

纳入2006年至2017年在我们诊所接受脉冲DRG射频治疗的患者。阳性反应定义为第30天时疼痛评分较基线降低≥50%。使用逻辑回归分析评估患者的人口统计学、疼痛相关因素和临床因素,以确定治疗阳性反应的预测因素。

结果

共有60例患者符合研究方案要求。28例患者(46.7%)有阳性结果。多因素逻辑回归分析显示,无合并症肌肉骨骼疼痛(OR=0.518,95%CI=0.029-0.858,P=0.033)和对先前硬膜外类固醇注射有阳性反应(OR=3.269,95%CI=1.046-10.215,P=0.042)是脉冲DRG射频治疗镇痛效果的独立预测因素。

结论

合并症肌肉骨骼疼痛和先前硬膜外注射反应似乎会影响慢性腰骶神经根性疼痛患者脉冲DRG射频治疗的结果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d4c8/6027680/ac36d05b48f6/jpr-11-1223Fig1.jpg

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