GSpine4, IRCCS Ospedale Galeazzi - Sant'Ambrogio, Milan, Italy.
Department of Trauma and Orthopaedic Surgery, Faculty of Medicine and Psychology, University La Sapienza, 00185, Rome, Italy.
J Orthop Surg Res. 2024 Apr 18;19(1):248. doi: 10.1186/s13018-024-04741-9.
Conservative management is recommended as the first therapeutic step in chronic low back pain (LBP), but there is no available evidence regarding the possible effect of patients' baseline characteristics on the therapeutic outcomes. A systematic review of the literature was performed to investigate this point.
In February 2024, all the level I studies investigating the role of pharmacological management for chronic LBP were accessed. Data concerning the patient demographic at baseline were collected: number of patients and related mean BMI and age, duration of the symptoms, duration of the follow-up, percentage of females, Numeric Rating Scale (NRS), the Roland Morris Disability Questionnaire (RMQ), Oswestry Disability Index (ODI). The outcomes at the last follow-up were evaluated through NRS, RMQ, and ODI. A multiple linear model regression diagnostic through the Pearson Product-Moment Correlation Coefficient (r) was used.
Data from 47 articles (9007 patients) were obtained. The analysis yielded the following significant associations: age at baseline and NRS at follow-up (r = - 0.22; P = 0.04), NRS at baseline with NRS (r = 0.26; P = 0.03) and RMQ (r = - 0.58; P = 0.02) at follow-up, RMQ at baseline and the same at follow-up (r = 0.69; P = 0.0001).
Older age, higher BMI, presence of comorbidities, higher ODI and a long history of symptoms or surgical treatments do not reduce the efficacy of pharmacological management of chronic LBP. However, pharmacological therapy is not an effective option for patients with high baseline RMQ.
I systematic review of RCTs.
慢性下背痛（LBP）的首选治疗方法是保守治疗，但目前尚无关于患者基线特征对治疗结果可能产生影响的证据。为此，我们进行了一项系统性文献回顾。
2024 年 2 月，我们检索了所有关于药物治疗慢性 LBP 的 I 级研究。收集基线时患者的人口统计学数据：患者数量和相关的平均 BMI 与年龄、症状持续时间、随访时间、女性比例、数字评分量表（NRS）、Roland Morris 残疾问卷（RMQ）、Oswestry 残疾指数（ODI）。通过 NRS、RMQ 和 ODI 评估末次随访时的结果。采用 Pearson 积矩相关系数（r）进行多元线性模型回归诊断。
共获得 47 篇文章（9007 例患者）的数据。分析发现以下显著关联：基线年龄与随访时 NRS（r=-0.22；P=0.04）、基线 NRS 与随访时 NRS（r=0.26；P=0.03）和 RMQ（r=-0.58；P=0.02）、基线 RMQ 与随访时 RMQ（r=0.69；P=0.0001）。
年龄较大、BMI 较高、合并症、ODI 较高以及症状或手术治疗史较长并不降低慢性 LBP 药物治疗的疗效。然而，药物治疗对于基线 RMQ 较高的患者不是有效的选择。
RCT 的系统评价。
