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从患者角度体验失败的脊柱手术后综合征的脊髓刺激:一种定性驱动的混合方法分析。

Experiences From the Patient Perspective on Spinal Cord Stimulation for Failed Back Surgery Syndrome: A Qualitatively Driven Mixed Method Analysis.

机构信息

Department of Anaesthesiology, Pain and Palliative Medicine, Radboud University Medical Center, Nijmegen, The Netherlands.

Department of Neurosurgery, Radboud University Medical Center, Nijmegen, The Netherlands.

出版信息

Neuromodulation. 2021 Jan;24(1):112-125. doi: 10.1111/ner.13277. Epub 2020 Sep 23.


DOI:10.1111/ner.13277
PMID:32969151
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7891647/
Abstract

INTRODUCTION: When neither pharmacological therapies nor alternative interventions provide sufficient pain relief, spinal cord stimulation (SCS) can be used to treat Failed Back Surgery Syndrome (FBSS). Although it seems reasonable that quality of life (QoL)- and psychosocial-related factors contribute to the outcome of SCS since pain is a multidimensional experience, few qualitative studies have explored the expectations of SCS and experiences on SCS to treat FBSS from the patient perspective. OBJECTIVES: The aim of this study was to qualitatively and quantitatively map the FBSS patients' experiences with SCS and the effects of SCS on low back pain caused by FBSS. MATERIALS AND METHODS: A qualitative study with in-depth semi-structured interviews, assisted by the Brief Pain Inventory (BPI)-questionnaire. RESULTS: Seven themes regarding patients' experiences, subdivided into 15 categories, were identified, including an understudied theme within this field of research, Spiritual Well-Being. "Acceptance" and "coping" emerged as pre-eminent motifs throughout these themes. Moreover, the realization of patients' expectations were variable throughout the presented themes. According to the BPI Questionnaire, four out of 13 patients (31%) had significant pain relief (≥50%). Seven out of 13 (54%) reported a ≥50% increase regarding enjoyment of life. CONCLUSION: Multiple QoL- and psychosocial-related themes are related to SCS-outcomes. In order to improve SCS-outcomes for both short- and long-term, these themes should be implemented as a multidimensional approach, both prior to implantation as during follow-up.

摘要

简介:当药物治疗和替代干预都不能提供足够的疼痛缓解时,可以使用脊髓刺激(SCS)来治疗失败的腰椎手术综合征(FBSS)。尽管从疼痛是一种多维体验的角度来看,生活质量(QoL)和心理社会相关因素可能会影响 SCS 的结果,这似乎是合理的,但很少有定性研究从患者角度探讨 SCS 的期望以及 SCS 治疗 FBSS 的经验。

目的:本研究的目的是从定性和定量两方面描述 FBSS 患者对 SCS 的体验以及 SCS 对 FBSS 引起的腰痛的影响。

材料和方法:采用定性研究方法,对 13 名患者进行深入的半结构化访谈,并辅以简短疼痛量表(BPI)问卷。

结果:确定了七个与患者体验相关的主题,细分为 15 个类别,其中包括该研究领域中一个被低估的主题,即精神健康。“接受”和“应对”是这些主题中突出的主题。此外,患者期望的实现在整个主题中各不相同。根据 BPI 问卷,13 名患者中有 4 名(31%)疼痛明显缓解(≥50%)。13 名患者中有 7 名(54%)报告生活享受度提高≥50%。

结论:多个与 QoL 和心理社会相关的主题与 SCS 结果相关。为了提高 SCS 的短期和长期效果,这些主题应该作为一个多维的方法来实施,包括在植入前和随访期间。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4f06/7891647/fda98fe74fbc/NER-24-112-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4f06/7891647/a1333bb6a7a5/NER-24-112-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4f06/7891647/fda98fe74fbc/NER-24-112-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4f06/7891647/a1333bb6a7a5/NER-24-112-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4f06/7891647/fda98fe74fbc/NER-24-112-g002.jpg

相似文献

[1]
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[3]
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[4]
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[5]
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[6]
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[7]
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[1]
Preoperative Suffering of Patients with Central Neuropathic Pain and Their Expectations Prior to Motor Cortex Stimulation: A Qualitative Study.

Healthcare (Basel). 2025-8-4

[2]
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BMJ Open. 2025-3-24

[3]
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J Clin Med. 2025-2-21

[4]
Neuromodulation perception by the general public.

Sci Rep. 2025-2-15

[5]
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Interv Neuroradiol. 2024-9-5

[6]
Clinical Patient-Relevant Outcome Domains for Persistent Spinal Pain Syndrome-A Scoping Review and Expert Panels.

J Clin Med. 2024-3-28

[7]
Spinal Cord Stimulation Meets Them All: An Effective Treatment for Different Pain Conditions. Our Experience and Literature Review.

Acta Neurochir Suppl. 2023

[8]
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Reg Anesth Pain Med. 2023-6

[9]
Changes in quantitative sensory testing and patient perspectives following spinal cord stimulation for persistent spinal pain syndrome: An observational study with long-term follow-up.

Eur J Pain. 2022-8

本文引用的文献

[1]
Goal Identification Before Spinal Cord Stimulation: A Qualitative Exploration in Potential Candidates.

Pain Pract. 2019-11-11

[2]
An Exploration of the Experiences and Educational Needs of Patients With Failed Back Surgery Syndrome Receiving Spinal Cord Stimulation.

Neuromodulation. 2019-4

[3]
How to empower patients? A systematic review and meta-analysis.

Transl Behav Med. 2018-9-8

[4]
Long-Term Outcome of Spinal Cord Stimulation in Failed Back Surgery Syndrome: 20 Years of Experience With 224 Consecutive Patients.

Neurosurgery. 2019-5-1

[5]
Spinal Cord Stimulation 50 Years Later: Clinical Outcomes of Spinal Cord Stimulation Based on Randomized Clinical Trials-A Systematic Review.

Reg Anesth Pain Med. 2018-5

[6]
Therapy-Related Explants After Spinal Cord Stimulation: Results of an International Retrospective Chart Review Study.

Neuromodulation. 2017-10

[7]
Patients' Expectations on Spinal Cord Stimulation for Failed Back Surgery Syndrome: A Qualitative Exploration.

Pain Pract. 2018-4

[8]
The Efficacy of High-Density Spinal Cord Stimulation Among Trial, Implant, and Conversion Patients: A Retrospective Case Series.

Neuromodulation. 2017-10

[9]
Moving beyond pain scores: Multidimensional pain assessment is essential for adequate pain management after surgery.

PLoS One. 2017-5-10

[10]
Spinal Cord Stimulation in Failed Back Surgery Syndrome: Review of Clinical Use, Quality of Life and Cost-Effectiveness.

Asian Spine J. 2016-12

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