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颈椎前路椎间盘切除融合术治疗退行性颈椎病后生活质量的心理预测因素。

Psychological predictors of quality of life after anterior cervical discectomy and fusion for degenerative cervical spine disease.

机构信息

Department of Neurosurgery, Klinikum Rechts der Isar, Technical University Munich School of Medicine, Ismaninger Str. 22, 81675, Munich, Germany.

Department of Clinical Psychology, Private University of Applied Sciences, Göttingen, Germany.

出版信息

Sci Rep. 2020 Aug 7;10(1):13415. doi: 10.1038/s41598-020-70437-9.

DOI:10.1038/s41598-020-70437-9
PMID:32770143
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7414876/
Abstract

We aimed to identify independent psychological predictors of quality of life (QOL) and functional outcome after anterior cervical discectomy and fusion (ACDF) for degenerative cervical spine disease. We prospectively included patients undergoing ACDF for degenerative cervical disc herniation and stenosis. Patients completed a structured psychological assessment including the Center for Epidemiological Studies Depression Scale (ADS-K), Post-Traumatic Stress Scale-10 (PTSS-10), State Trait Anxiety Inventory-State Anxiety and - Trait Anxiety (STAI-S and STAI-T) and Anxiety Sensitivity Index-3 (ASI-3) before surgery, after 3 and 12 months. Outcome measures included EuroQol-5D (EQ), Short Form-36 (SF-36) and Oswestry Disability Index (ODI) scores. Of 104 included patients who underwent ACDF between March 2013 and November 2017, 92 completed follow-up after 3 and 12 months. The mean Visual Analogue Scale (VAS) scores for neck pain (- 1.4; p < .001) and arm pain (- 1.8; p = .031) significantly decreased by 12 months. QOL scores significantly increased by 3 months (EQ: + 0.2; p < .001; SF-36 PCS: + 6.2; p < .001; SF-36 MCS: + 2.5; p = .044), a benefit which was retained at 12 months. Linear regression analyses identified statistically significant predictors in preoperative ASI-3, SF-36 MCS and STAI-S for postoperative QOL and ODI scores. There is a benefit for patients in terms of quality of life and function after undergoing surgery for degenerative cervical spine disease. With the ASI-3, SF-36 MCS and STAI-S there exist some predictors for postoperative QOL and ODI scores.

摘要

我们旨在确定退行性颈椎疾病前路颈椎间盘切除融合术(ACDF)后生活质量(QOL)和功能结果的独立心理预测因素。我们前瞻性纳入了接受 ACDF 治疗退行性颈椎间盘突出症和狭窄症的患者。患者在术前、术后 3 个月和 12 个月时完成了一项包括流行病学研究中心抑郁量表(ADS-K)、创伤后应激量表-10(PTSS-10)、状态特质焦虑量表-状态焦虑和特质焦虑(STAI-S 和 STAI-T)以及焦虑敏感指数-3(ASI-3)的结构化心理评估。结果测量包括 EuroQol-5D(EQ)、36 项简短健康调查(SF-36)和 Oswestry 残疾指数(ODI)评分。在 2013 年 3 月至 2017 年 11 月期间接受 ACDF 的 104 名患者中,92 名患者在术后 3 个月和 12 个月时完成了随访。12 个月时,颈痛(-1.4;p<0.001)和臂痛(-1.8;p=0.031)的视觉模拟评分(VAS)显著降低。3 个月时 QOL 评分显著增加(EQ:+0.2;p<0.001;SF-36 PCS:+6.2;p<0.001;SF-36 MCS:+2.5;p=0.044),12 个月时仍保持获益。线性回归分析确定了术前 ASI-3、SF-36 MCS 和 STAI-S 对术后 QOL 和 ODI 评分的统计学显著预测因素。退行性颈椎疾病患者术后生活质量和功能均有获益。ASI-3、SF-36 MCS 和 STAI-S 对术后 QOL 和 ODI 评分有一定的预测作用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6769/7414876/5e9ba2b506e2/41598_2020_70437_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6769/7414876/f744dc68e5c1/41598_2020_70437_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6769/7414876/def8d7f50a59/41598_2020_70437_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6769/7414876/5e9ba2b506e2/41598_2020_70437_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6769/7414876/f744dc68e5c1/41598_2020_70437_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6769/7414876/def8d7f50a59/41598_2020_70437_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6769/7414876/5e9ba2b506e2/41598_2020_70437_Fig3_HTML.jpg

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