Department of Neurosurgery, Justus-Liebig-University Giessen, Giessen, Germany.
Department of Psychosomatics and Psychotherapy, Justus-Liebig-University Giessen, Giessen, Germany.
Neuromodulation. 2021 Aug;24(6):1042-1050. doi: 10.1111/ner.13368. Epub 2021 Feb 1.
Peripheral nerve field stimulation (PNFS) is an effective alternative treatment for patients with chronic low back pain. The treatment of low back pain strongly depends on psychological factors like anxiety, depression, and mental stress. The aim of this study was to evaluate the impact of such factors on outcome measures after lead- and implantable pulse generator-implantation.
Between 2014 and 2019, a prospective cohort study of 39 patients with chronic lumbar pain was conducted. Hospital Anxiety and Depression Scale (HADS) score was assessed at baseline to measure symptoms of anxiety and depression. Symptom checklist-90 (SCL-90) was used to measure subjective psychopathology. Pain intensity (numeric pain rating scale [NRS]), SF12v2 with Physical Component Summary and Mental Component Summary (MCS) scores, and Oswestry Disability Index (ODI) were assessed pre- and postoperatively as well as three and six months after PNFS implantation. Outcome values were compared to baseline data. Statistical analysis was performed using depending t-test and analysis of variance (ANOVA). A p value <0.05 was considered significant.
The cohort consisted of 39 patients (18 females, 21 males) with a median age of 61 years (IQR = 52-67 years). NRS, ODI, and SF12v2 showed significant improvement in the whole follow-up period compared to baseline values (p < 0.05). Elevated HADS scores for anxiety were seen in 64.1%, for depression in 76.9% of the patients at baseline. SCL-90 was pathologic in 71.8% of the cases. A one-way ANOVA revealed no differences between elevated HADS- and SCL-90 values and all outcome measures after PNFS implantation in the whole follow-up period (p > 0.05).
Chronic low back pain is often associated with psychological distress. Our study showed highly elevated levels for anxiety and depression as well as subjective mental stress in patients with chronic low back pain without negative impact on NRS, ODI, and SF12v2 in the whole follow-up after PNFS implantation.
外周神经场刺激（PNFS）是治疗慢性腰痛患者的有效替代疗法。腰痛的治疗强烈依赖于焦虑、抑郁和精神压力等心理因素。本研究旨在评估这些因素对置管和植入式脉冲发生器植入术后结局评估的影响。
2014 年至 2019 年期间，对 39 例慢性腰痛患者进行前瞻性队列研究。在基线时使用医院焦虑和抑郁量表（HADS）评分评估焦虑和抑郁症状。使用症状清单 90（SCL-90）评估主观精神病理学。在术前、术后以及 PNFS 植入后 3 个月和 6 个月时评估疼痛强度（数字疼痛评分量表 [NRS]）、SF12v2 中的生理成分综合评分和心理成分综合评分（MCS）以及 Oswestry 残疾指数（ODI）。将结局值与基线数据进行比较。使用依赖 t 检验和方差分析（ANOVA）进行统计分析。p 值<0.05 被认为具有统计学意义。
该队列包括 39 例患者（18 名女性，21 名男性），中位年龄为 61 岁（IQR=52-67 岁）。NRS、ODI 和 SF12v2 在整个随访期间与基线值相比均有显著改善（p<0.05）。基线时，64.1%的患者 HADS 焦虑评分升高，76.9%的患者 HADS 抑郁评分升高。71.8%的患者 SCL-90 存在病理学表现。单因素方差分析显示，在整个随访期间，PNFS 植入后 HADS 和 SCL-90 升高值与所有结局评估之间无差异（p>0.05）。
慢性腰痛常伴有心理困扰。我们的研究显示，慢性腰痛患者焦虑和抑郁水平显著升高，主观精神压力较大，但在 PNFS 植入后整个随访期间，NRS、ODI 和 SF12v2 并未受到负面影响。
