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多中心研究中对接受择期脊柱手术患者的中枢敏化量表评估

Evaluation of Central Sensitization Inventory in Patients Undergoing Elective Spine Surgery in a Multicenter Study.

作者信息

Akeda Koji, Yamada Junichi, Takegami Norihiko, Fujiwara Tatsuhiko, Murata Koichiro, Kono Toshibumi, Sudo Takao, Imanishi Takao, Asanuma Yumiko, Kurata Tatsuya, Kawakita Eiji, Sakakibara Toshihiko, Kondo Tetsushi, Takegami Kenji, Sato Masayoshi, Sudo Akihiro

机构信息

Department of Orthopaedic Surgery, Mie University Graduate School of Medicine, Tsu, Japan.

Department of Orthopedic Surgery, Iwasaki Hospital, Tsu, Japan.

出版信息

Global Spine J. 2023 Sep;13(7):1716-1727. doi: 10.1177/21925682211047473. Epub 2021 Oct 21.

Abstract

STUDY DESIGN

This study is a retrospective review.

OBJECTIVE

Central sensitization (CS) is a neurological phenomenon that involves hypersensitivity of the central nervous system. The central sensitization inventory (CSI) was developed as a screening tool to assess CS-related symptoms. The purpose of this study was to evaluate the association of preoperative CSI scores with patient-reported outcome measures (PROMs) including neurological symptoms for patients who underwent spine surgeries in a multicenter study.

METHODS

A consecutive 673 patients who underwent spine surgery at 8 different institutions were included in this study. Preoperative CSI scores were assessed for all subjects. The participants completed the following PROMs: the Oswestry Disability Index (ODI), the Japanese Orthopaedic Association (JOA) back pain evaluation questionnaire (JOABPEQ) for lumbar spinal diseases, and the JOA cervical myelopathy evaluation questionnaire (JOACMEQ) for cervical spinal diseases. The association of CSI scores with PROMs was statistically evaluated.

RESULTS

The average CSI score for the total subjects was 23.6 ± 13.5. The subjects with CS-related symptoms (CSI ≥ 40) were 13.2% (n = 89). The CSI score showed a significant and weak-to-moderate correlation with the PROMs including neurological symptoms that included all the domains of the JOACMEQ for cervical spinal diseases, and JOABPEQ and ODI for lumbar spinal diseases. Among these, psychological factors had the most influence on the correlation with CSI score.

CONCLUSION

Central sensitization evaluated by the CSI is related to neurological symptoms and health-related quality of life in patients undergoing elective spine surgery.

摘要

研究设计

本研究为回顾性研究。

目的

中枢敏化(CS)是一种涉及中枢神经系统超敏反应的神经学现象。中枢敏化量表(CSI)被开发作为一种评估与CS相关症状的筛查工具。本研究的目的是在一项多中心研究中,评估接受脊柱手术患者术前CSI评分与患者报告结局指标(PROMs)之间的关联,这些指标包括神经症状。

方法

本研究纳入了在8个不同机构接受脊柱手术的连续673例患者。对所有受试者进行术前CSI评分评估。参与者完成了以下PROMs:Oswestry功能障碍指数(ODI)、用于腰椎疾病的日本骨科协会(JOA)背痛评估问卷(JOABPEQ)以及用于颈椎病的JOA脊髓病评估问卷(JOACMEQ)。对CSI评分与PROMs之间的关联进行了统计学评估。

结果

所有受试者的平均CSI评分为23.6±13.5。有CS相关症状(CSI≥40)的受试者占13.2%(n = 89)。CSI评分与PROMs呈显著且弱至中度相关,这些PROMs包括神经症状,其中包括用于颈椎病的JOACMEQ的所有领域,以及用于腰椎疾病的JOABPEQ和ODI。其中,心理因素对与CSI评分的相关性影响最大。

结论

通过CSI评估的中枢敏化与接受择期脊柱手术患者的神经症状和健康相关生活质量有关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/96b2/10556898/226c8d36afd8/10.1177_21925682211047473-fig1.jpg

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