Zhao Yina, Hemmer Stefan, Pepke Wojciech, Akbar Michael, Schiltenwolf Marcus, Dapunt Ulrike
Center for Orthopedics, Trauma Surgery and Spinal Cord Injury, Heidelberg University Hospital, Schlierbacher Landstrasse 200a, 69118 Heidelberg, Germany.
Clinic for Spinal Diseases, Meoclinic Berlin, Friedrichstrasse 71, 10117 Berlin, Germany.
J Clin Med. 2020 Dec 15;9(12):4056. doi: 10.3390/jcm9124056.
Spinal infections represent a therapeutic challenge. The often protracted course of the disease is accompanied by pain, which can lead to a chronic pain experience even after the infectious disease has been treated successfully. The aim of this study was to investigate possible risk factors of pain chronification.
In a prospective study, 14 patients with spinal infections were examined at admission (T1), at discharge from inpatient therapy (T2), and three to eight months postoperatively (T3) byquestionnaires on risk factors for pain chronification and by quantitative sensory testing (QST).
In-patient treatment lasted on average 45.3 days (±33.13). The patients complained of pain for 3.43 months (±2.77) prior to inpatient treatment. The visual analogue scale (VAS) for pain (0-10) and the Oswestry Disability Index detected significant improvement in the course of the study. However, patients also reported catastrophic thinking, as well as fear of movement and (re)-injury.
In summary, our results demonstrate that patients with spinal infections did not suffer from pain chronification, but might benefit from an interdisciplinary therapeutic approach, which emphasizes promoting active pain-coping strategies, as well as addressing fear of movement and catastrophic thinking.
脊柱感染是一项治疗挑战。疾病病程往往迁延,伴有疼痛,即便传染病已成功治愈,仍可能导致慢性疼痛体验。本研究旨在调查疼痛慢性化的可能危险因素。
在一项前瞻性研究中,对14例脊柱感染患者在入院时(T1)、住院治疗出院时(T2)以及术后三至八个月(T3)进行了关于疼痛慢性化危险因素的问卷调查和定量感觉测试(QST)。
住院治疗平均持续45.3天(±33.13)。患者在住院治疗前疼痛3.43个月(±2.77)。在研究过程中,疼痛视觉模拟量表(VAS,0 - 10)和奥斯维斯特残疾指数显示有显著改善。然而,患者也报告了灾难性思维以及对活动和(再)受伤的恐惧。
总之,我们的结果表明,脊柱感染患者并未出现疼痛慢性化,但可能受益于一种跨学科治疗方法,该方法强调促进积极的疼痛应对策略以及解决对活动的恐惧和灾难性思维。