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使用患者报告的疼痛结局工具评估非器械辅助腰椎减压手术治疗退变性腰椎疾病的疼痛结局

Pain outcome of non-instrumented lumbar decompressive surgery for degenerative lumbar spine disease using patient-reported pain outcome instruments.

作者信息

Inojie Moses Osaodion, Ndubuisi Chika Anele, Okwunodulu Okwuoma, Inojie Okiemute Vanita, Ndafia Ned Micheal, Ohaegbulam Samuel Chwukwunoyerem

机构信息

Department of SurgeryFederal Medical Centre, Asaba, Delta State, Nigeria.

Department of Neurosurgery, Memfys Hospital, Enugu, Nigeria.

出版信息

J Neurosci Rural Pract. 2024 Jan-Mar;15(1):47-52. doi: 10.25259/JNRP_80_2022. Epub 2023 Nov 2.

Abstract

OBJECTIVES

A clinical disorder known as degenerative lumbar spine disease (DLSD) is characterized by persistent low back pain (LBP) coupled with radiculopathy and other signs of neurologic impairment. Using patient-reported pain outcome assessment tools, this study evaluated the pain outcome of non-instrumented lumbar decompressive surgery for DLSD.

MATERIALS AND METHODS

A prospective longitudinal research was conducted. Using the metric visual analog scale (VAS) score and the Oswestry disability index (ODI), consenting patients who underwent non-instrumented lumbar decompressive surgery for symptomatic DLSD were evaluated for radicular pain and LBP. The evaluation was conducted both immediately before surgery and 6 months after surgery. Data generated by comparing the pre-operative and post-operative VAS and ODI scores were then analyzed using descriptive and inferential statistics.

RESULTS

Sixty-seven patients in total completed the study. Thirty-six (54%) males and 31 (46%) females, with a mean age and body mass index of 55.28 years and 29.5 k/m, respectively. At 6 months postoperatively, there was significant pain reduction from the pre-operative baseline VAS for LBP (67.12-32.74) with < 0.001, VAS for radicular pain (75.39-32.75) with < 0.001, and ODI (65.30-27.66) with < 0.001. There was a greater decrease in radicular pain than in LBP following lumbar decompressive only surgery ( = 0.03).

CONCLUSION

Patients with symptomatic DLSD and high pre-operative back pain scores without considerable listhesis should anticipate a significant reduction in radicular and back pain intensity, as well as pain-related functional disability, 6 months after non-instrumented lumbar decompressive surgery.

摘要

目的

一种称为退行性腰椎疾病(DLSD)的临床病症,其特征为持续性下腰痛(LBP)并伴有神经根病及其他神经功能损害迹象。本研究使用患者报告的疼痛结局评估工具,评估了非器械辅助腰椎减压手术治疗DLSD的疼痛结局。

材料与方法

进行了一项前瞻性纵向研究。使用公制视觉模拟量表(VAS)评分和奥斯威斯功能障碍指数(ODI),对因有症状的DLSD接受非器械辅助腰椎减压手术的同意参与研究的患者进行神经根性疼痛和LBP评估。评估在手术前即刻和手术后6个月进行。然后使用描述性和推断性统计分析比较术前和术后VAS及ODI评分所产生的数据。

结果

共有67例患者完成了研究。其中男性36例(54%),女性31例(46%),平均年龄和体重指数分别为55.28岁和29.5kg/m²。术后6个月,与术前基线相比,LBP的VAS(从67.12降至32.74)、神经根性疼痛的VAS(从75.39降至32.75)和ODI(从65.30降至27.66)均有显著疼痛减轻,P均<0.001。单纯腰椎减压手术后,神经根性疼痛的减轻幅度大于LBP(P = 0.03)。

结论

有症状的DLSD且术前背痛评分高且无明显椎体滑脱的患者,在接受非器械辅助腰椎减压手术后6个月,应预期神经根性疼痛和背痛强度以及与疼痛相关的功能障碍会显著减轻。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/38a0/10927036/ca6ba6d9ef19/JNRP-15-047-g001.jpg

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