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腰椎间盘突出症:医学治疗与手术干预后的疼痛缓解比较

Lumbar Disc Herniation: Comparing Pain Relief After Medical and Surgical Intervention.

作者信息

Abdullah Fnu, Bai Amerta, Sahil Fnu, Kataria Deepak, Abbas Mohammed, Ullah Farhan, Naz Sidra, Jamil Amna, Fatima Aliya, Memon Sidra

机构信息

Neurology, Jinnah Sindh Medical University, Karachi, PAK.

Internal Medicine, Shaheed Mohtarma Benazir Bhutto Medical University, Larkana, PAK.

出版信息

Cureus. 2021 Jun 24;13(6):e15885. doi: 10.7759/cureus.15885. eCollection 2021 Jun.

Abstract

Introduction The most common degenerative abnormality of the lumbar spine is lumbar disc herniation. There are two options of treatment, i.e. medical and surgical. Due to the scarcity of literature, it is a need of the hour to further study and evaluate the benefits and efficacy of early surgical intervention versus conservative management of lumbar disc herniation. Methods This study was conducted in the neurology unit of a tertiary care hospital in Pakistan from April 2019 to March 2021. After obtaining informed consent, 250 patients with a lumbar disc herniation, between the ages of 20 and 50 years, were enrolled in the study. Out of them, 81 participants chose surgical intervention while 169 participants chose medical intervention. Before the intervention, the patient's pain score was noted on the visual analog scale (VAS). The pain was assessed again 14 days after surgical intervention and 90 days after the start of medical intervention. Results There was a significant difference in the pain score in the post-intervention period in both the medical (7.01 ± 1.05 vs. 3.54 ± 0.51; p-value: <0.0001) and surgical intervention groups (6.92 ± 0.95 vs. 2.41 ± 0.42; p-value: <0.0001). Post-intervention, the VAS pain score was significantly lower in the surgical group as compared to the medical group (2.41 ± 0.42 vs. 3.54 ± 0.51; p-value: <0.0001). Conclusion In this study, there was a significant decline in pain in both groups; however, the reduction was more significant in the surgical group. Patients should be given both options for management of lumbar disc herniation and should be explained the pros and cons of each treatment option.

摘要

引言 腰椎最常见的退行性异常是腰椎间盘突出症。治疗方法有两种,即药物治疗和手术治疗。由于文献资料匮乏,当下亟需进一步研究和评估早期手术干预与腰椎间盘突出症保守治疗的益处和疗效。

方法 本研究于2019年4月至2021年3月在巴基斯坦一家三级护理医院的神经科进行。在获得知情同意后,纳入了250名年龄在20至50岁之间的腰椎间盘突出症患者。其中,81名参与者选择手术干预,169名参与者选择药物干预。在干预前,通过视觉模拟量表(VAS)记录患者的疼痛评分。在手术干预后14天和药物干预开始后90天再次评估疼痛情况。

结果 药物治疗组(7.01±1.05 vs. 3.54±0.51;p值:<0.0001)和手术干预组(6.92±0.95 vs. 2.41±0.42;p值:<0.0001)在干预后时期的疼痛评分均有显著差异。干预后,手术组的VAS疼痛评分显著低于药物治疗组(2.41±0.42 vs. 3.54±0.51;p值:<0.0001)。

结论 在本研究中,两组的疼痛均有显著下降;然而,手术组的疼痛减轻更为显著。对于腰椎间盘突出症患者,应提供两种治疗选择,并向其解释每种治疗方案的利弊。

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