术前下腰痛影响微创经椎间孔腰椎椎间融合术后患者的满意度。
Preoperative Low Back Pain Affects Postoperative Patient Satisfaction Following Minimally Invasive Transforaminal Lumbar Interbody Fusion Surgery.
作者信息
Hiranaka Yoshiaki, Miyazaki Shingo, Inoue Shinichi, Ryu Masao, Yurube Takashi, Kakutani Kenichiro, Tadokoro Ko
机构信息
Department of Orthopaedic Surgery, Anshin Hospital, Kobe, Japan.
Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan.
出版信息
Asian Spine J. 2023 Aug;17(4):750-760. doi: 10.31616/asj.2022.0313. Epub 2023 Jul 6.
STUDY DESIGN
A single-center retrospective study.
PURPOSE
To research the predictive factors associated with postoperative patient satisfaction 1 year after minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF), a minimally invasive procedure for lumbar degenerative disease.
OVERVIEW OF LITERATURE
There have been reports of numerous variables influencing patient satisfaction with lumbar surgery; however, there have been few investigations on MIS are limited.
METHODS
This study included 229 patients (107 men and 122 women; mean age, 68.9 years) who received one or two levels of MISTLIF, and the patient's age, gender, disease, paralysis, preoperative physical functions, duration of symptom(s), and surgery-associated factors (waiting for surgery, number of surgical levels, surgical time, and intraoperative blood loss) were studied. Radiographic characteristics and clinical outcomes such as Oswestry Disability Index (ODI) scores and Visual Analog Scale (VAS; 0-100) ODI scores for low back pain, leg pain, and numbness were studied. One year following surgery, patient satisfaction (defined as satisfaction for surgery and for present condition; 0-100) was assessed using VAS and its relationships with investigation factors were examined.
RESULTS
The mean VAS scores of satisfaction for surgery and for present condition were 88.6 and 84.2, respectively. The results of multiple regression analysis showed that preoperative adverse factors of satisfaction for surgery were being elderly (β =-0.17, p =0.023), high preoperative low back pain VAS scores (β =-0.15, p =0.020), and postoperative adverse factors were high postoperative ODI scores (β =-0.43, p <0.001). In addition, the preoperative adverse factor of satisfaction for present condition was high preoperative low back pain VAS scores (β =-0.21, p =0.002), and postoperative adverse factors were high postoperative ODI scores (β =-0.45, p <0.001) and high postoperative low back pain VAS scores (β =-0.26, p =0.001).
CONCLUSIONS
According to this study, significant preoperative low back pain and high postoperative ODI score after surgery are linked to patient unhappiness.
研究设计
单中心回顾性研究。
目的
研究与微创经椎间孔腰椎椎体间融合术（MIS-TLIF，一种用于治疗腰椎退行性疾病的微创手术）术后1年患者满意度相关的预测因素。
文献综述
已有众多影响腰椎手术患者满意度的变量的报道；然而，关于MIS的研究有限。
方法
本研究纳入了229例接受一或两个节段MIS-TLIF手术的患者（107例男性和122例女性；平均年龄68.9岁），研究了患者的年龄、性别、疾病、瘫痪情况、术前身体功能、症状持续时间以及手术相关因素（等待手术时间、手术节段数、手术时间和术中失血量）。研究了影像学特征和临床结局，如Oswestry功能障碍指数（ODI）评分以及视觉模拟量表（VAS；0 - 100）用于评估腰痛、腿痛和麻木的ODI评分。术后1年，使用VAS评估患者满意度（定义为对手术和当前状况的满意度；0 - 100），并检查其与调查因素的关系。
结果
手术和当前状况的满意度的平均VAS评分分别为88.6和84.2。多元回归分析结果显示，手术满意度的术前不利因素为年龄较大（β = -0.17，p = 0.023）、术前腰痛VAS评分较高（β = -0.15，p = 0.020），术后不利因素为术后ODI评分较高（β = -0.43，p < 0.001）。此外，当前状况满意度的术前不利因素为术前腰痛VAS评分较高（β = -0.21，p = 0.002），术后不利因素为术后ODI评分较高（β = -0.45，p < 0.001）和术后腰痛VAS评分较高（β = -0.26，p = 0.001）。
结论
根据本研究，术前严重腰痛和术后高ODI评分与患者不满意相关。
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