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腰椎间盘手术后患者的生活质量、残疾程度和疼痛强度:一项为期三个月的观察性随访研究。

Quality of Life, Disability Level, and Pain Intensity among Patients after Lumbar Disc Surgery: An Observational Three-Month Follow-Up Study.

作者信息

Michalak Monika, Druszcz Adam, Miś Maciej, Paprocka-Borowicz Małgorzata, Rosińczuk Joanna

机构信息

Department of Nursing and Obstetrics, Wroclaw Medical University, 51-618 Wroclaw, Poland.

Department of Neurosurgery, Provincial Specialist Hospital in Legnica, 59-220 Legnica, Poland.

出版信息

Healthcare (Basel). 2023 Dec 8;11(24):3127. doi: 10.3390/healthcare11243127.

Abstract

The prevalence of intervertebral disc degeneration in the lumbar region resulting in low back pain is high. One of the treatment options is neurosurgery. Previous studies and systematic reviews demonstrate the need to identify factors that affect the health-related quality of life of patients undergoing surgery. This study aimed to analyze the sociodemographic and clinical factors that affect the quality of life of patients undergoing lumbar disc surgery. A group of 128 patients was assessed for eligibility and qualified by radiological examinations for lumbar disc surgery by a neurosurgeon in the outpatient clinic. Finally, 110 patients were studied and evaluated 24 h and 3 months after surgery. Health-related quality of life (36-Item Short Form Survey, SF-36), disability level (Oswestry Disability Index, ODI), and pain intensity (Visual Analogue Scale, VAS) were assessed. The mean pain intensity before surgery was 7.8 ± 2.3 pts and decreased significantly 24 h after surgery, with a mean score of 3.8 ± 2.4 pts ( = 0.0000). After three months, the increase in pain intensity was at 4.8 ± 2.4 pts, but the score was still significantly better than before surgery ( = 0.0024). The mean ODI score before surgery was 29.3 ± 8.4 pts (slight disability), and three months after surgery, there was an insignificant increase to a mean value of 31.5 ± 10.4 pts ( = 0.0834). There was a statistically significant increase in quality-of-life scores at three months after surgery in the following domains: physical functioning (8.7%; = 0.0176), bodily pain (26.2%; = 0.0000), vitality (5.8%; = 0.0132) and mental health (6.2%; = 0.0163), and a decrease in role limitations due to physical problems (3.8; = 0.0013) and general health perception (6.7%; = 0.0112). In conclusion, the surgical procedure plays an important role in improving the quality of life of patients operated on for intervertebral disc degeneration. It was effective in reducing the pain level, especially 24 h after surgery; however, surgery did not affect the disability level.

摘要

腰椎间盘退变导致下腰痛的患病率很高。治疗选择之一是神经外科手术。先前的研究和系统评价表明,有必要确定影响接受手术患者健康相关生活质量的因素。本研究旨在分析影响腰椎间盘手术患者生活质量的社会人口学和临床因素。一组128例患者在门诊接受了神经外科医生的资格评估,并通过腰椎间盘手术的影像学检查合格。最后,对110例患者在术后24小时和3个月进行了研究和评估。评估了健康相关生活质量(36项简短调查问卷,SF-36)、残疾水平(Oswestry残疾指数,ODI)和疼痛强度(视觉模拟量表,VAS)。术前平均疼痛强度为7.8±2.3分,术后24小时显著降低,平均评分为3.8±2.4分(P=0.0000)。三个月后,疼痛强度增加至4.8±2.4分,但评分仍显著优于术前(P=0.0024)。术前平均ODI评分为29.3±8.4分(轻度残疾),术后三个月,平均分值无显著增加,为31.5±10.4分(P=0.0834)。术后三个月,在以下领域生活质量评分有统计学显著提高:身体功能(8.7%;P=0.0176)、身体疼痛(26.2%;P=0.0000)、活力(5.8%;P=0.0132)和心理健康(6.2%;P=0.0163),因身体问题导致的角色限制(3.8;P=0.0013)和总体健康感知(6.7%;P=0.0112)有所下降。总之,手术程序在改善因椎间盘退变而接受手术患者的生活质量方面发挥着重要作用。它在降低疼痛水平方面有效,尤其是术后24小时;然而,手术并未影响残疾水平。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/24c8/10742899/029565b66d8c/healthcare-11-03127-g001.jpg

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