Department of Neurosurgery, CHU Tours, 2 Boulevard de Tonnelle, 37000, Tours, France.
Physical Medicine and Rehabilitation Department, CHU de Tours, Tours, France.
Eur Spine J. 2022 Jan;31(1):167-175. doi: 10.1007/s00586-021-07049-y. Epub 2021 Nov 2.
The coronavirus 2019 (COVID-19) pandemic led to a compulsory lockdown of 3 months with strict restrictions. The impact of the COVID-19 pandemic has shown broad repercussions on patients with chronic pain; especially for conditions that present a significant emotional participation such as chronic low back pain (cLBP).
We performed a prospective study on 50 patients. Pre- and 1-month post-lockdown questionnaires such as: the Impact of Event Scale (IES), the Oswestry Disability Index (ODI), the Roland-Morris questionnaire (RMQ) and the visual analogue scale (VAS) for back and leg pain intensity were collected.
The mean time of the evolution of cLBP was 33.04 months (range 5-120 months). Eighteen (36%) patients improved their cLBP (i-cLBP), whereas for 14 (28%) it was worse (w-cLBP). Cox multivariate proportional hazard model identified that MODIC 1 disc disease [OR 19.93, IC95% (2.81-102.13), p = 0.015] and at-home workouts [OR 18.854, IC95% (1.151-204.9), p = 0.040] were good prognosis factors of the improvement of cLBP while subclinical/mild Covid-19 anxiety (IES score < 26) was a poor prognosis factor in improving cLBP [OR 0.21, IC95% (0.001-0.384), p = 0.009]. Furthermore, pre-lockdown benzodiazepine medication [OR 2.554, IC95% (1.20-9.9), p = 0.002] was a prognosis factor of worse cLBP. In contrast, patients with severe Covid-19 anxiety (IES score > 26) significantly improved their cLBP [OR 0.58, IC95% (0.025-0.834), p = 0.01].
Lockdown affected the somatic component of cLBP by decreasing activities and physical measures, whereas the SARS-CoV-2 pandemic spectrum paradoxically improved the psychic and emotional component of cLBP.
2019 年冠状病毒病（COVID-19）大流行导致了为期 3 个月的强制性封锁，实施了严格的限制措施。COVID-19 大流行对慢性疼痛患者产生了广泛影响；特别是对于那些表现出明显情绪参与的疾病，如慢性下腰痛（cLBP）。
我们对 50 名患者进行了前瞻性研究。在封锁前和封锁后 1 个月收集了以下问卷：事件影响量表（IES）、Oswestry 残疾指数（ODI）、Roland-Morris 问卷（RMQ）和背部和腿部疼痛强度的视觉模拟量表（VAS）。
cLBP 的平均病程为 33.04 个月（范围 5-120 个月）。18 名（36%）患者的 cLBP 得到改善（i-cLBP），而 14 名（28%）患者的 cLBP 恶化（w-cLBP）。Cox 多变量比例风险模型确定，MODIC 1 椎间盘疾病[OR 19.93，95%CI（2.81-102.13），p=0.015]和在家锻炼[OR 18.854，95%CI（1.151-204.9），p=0.040]是 cLBP 改善的良好预后因素，而亚临床/轻度 COVID-19 焦虑（IES 评分<26）是 cLBP 改善的不良预后因素[OR 0.21，95%CI（0.001-0.384），p=0.009]。此外，封锁前使用苯二氮䓬类药物[OR 2.554，95%CI（1.20-9.9），p=0.002]是 cLBP 恶化的预后因素。相比之下，COVID-19 严重焦虑（IES 评分>26）的患者显著改善了他们的 cLBP[OR 0.58，95%CI（0.025-0.834），p=0.01]。
封锁通过减少活动和身体措施影响了 cLBP 的躯体成分，而 SARS-CoV-2 大流行谱却奇异地改善了 cLBP 的心理和情绪成分。
