School of Nursing, Taipei Medical University, Taipei, Taiwan.
Department of Nursing, Taipei Medical University Hospital, Taipei, Taiwan.
BMJ Open Qual. 2023 Jan;12(1). doi: 10.1136/bmjoq-2022-001982.
Soreness is a common complaint in patients who receive lumbar spine surgery (LSS) for degenerative lumbar spine diseases (DLSD). However, soreness is not assessed independently and its impacts on outcomes of LSS remains largely unknown. Sng(pronounced sә-ng, ) in Chinese language is the word with the closest meaning to soreness, and Chinese-speaking people naturally use sng to describe their non-pain 'soreness' symptom. This study was aimed to investigate the prevalence and impacts of soreness or sng on outcome of LSS by introducing Visual Analogue Scale (VAS) of sng on back and leg.
This prospective cohort study recruited patients who receive LSS for DLSD. Participants completed the patient-reported outcome measures at 1 week before and 1 years after LSS. The patient-reported outcome measures included (1) VAS for back pain, leg pain, back sng and leg sng, (2) Oswestry Disability Index (ODI) and (3) RAND 36-item Short Form Health Survey. The minimal clinical important difference (MCID) of ODI and physical component health-related quality of life (HRQoL) was used.
A total of 258 consecutive patients were included and 50 dropped out at follow-up. Preoperatively, the prevalence of sng was comparable to pain both on back and leg; postoperatively, the prevalence of sng was higher than pain. Leg and back sng were associated with preoperative and postoperative mental HRQoL, respectively. The reduction of sng on back and leg were significantly less than pain postoperatively. Leg sng was the only symptom independently associated with attaining MCID.
Soreness or sng should be assessed independently from pain in patients receiving LSS for DLSD because soreness or sng had substantial clinical impacts on the outcome of LSS.
在因退行性腰椎疾病（DLSD）而行腰椎脊柱手术（LSS）的患者中，疼痛是常见的主诉。然而，疼痛并未单独评估，其对 LSS 结果的影响在很大程度上仍不清楚。Sng（发音为 sә-ng）在中文中是与疼痛最接近的词，讲中文的人自然会用 sng 来描述他们非疼痛的“疼痛”症状。本研究旨在通过在背部和腿部引入 sng 的视觉模拟量表（VAS），调查 LSS 术后疼痛或 sng 的发生率及其对 LSS 结果的影响。
本前瞻性队列研究招募了因 DLSD 而行 LSS 的患者。参与者在 LSS 前 1 周和 LSS 后 1 年完成了患者报告的结局测量。患者报告的结局测量包括：（1）背部疼痛、腿部疼痛、背部 sng 和腿部 sng 的 VAS；（2）Oswestry 残疾指数（ODI）；（3）RAND 36 项简短健康调查。使用 ODI 的最小临床重要差异（MCID）和身体成分健康相关生活质量（HRQoL）。
共纳入 258 例连续患者，50 例在随访时失访。术前，sng 的发生率与背部和腿部的疼痛相当；术后，sng 的发生率高于疼痛。腿部和背部 sng 分别与术前和术后的精神 HRQoL 相关。术后背部和腿部 sng 的缓解程度明显低于疼痛。腿部 sng 是唯一与达到 MCID 相关的症状。
在因 DLSD 而行 LSS 的患者中，sng 应与疼痛分开评估，因为 sng 在很大程度上对 LSS 的结果有临床影响。
