Nikolis Andrea, Nikolis Louis, Wynia Zan, Murillo Carlos, Friedrich Jason, Ashar Yoni K
Department of Physical Medicine & Rehabilitation, University of Colorado Anschutz Medical Campus, Aurora, CO, USA.
Division of Internal Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA.
Pain Rep. 2025 Apr 3;10(3):e1253. doi: 10.1097/PR9.0000000000001253. eCollection 2025 Jun.
Radiofrequency ablation (RFA) is commonly performed for facet-mediated cervical, thoracic, and lumbar spine pain. Inadequate relief from RFA may be because of biopsychosocial factors not addressed with RFA.
To investigate the effects of baseline emotional distress on RFA treatment response.
Patients who completed self-reported surveys, Patient-Reported Outcomes Measurement System (PROMIS), from January 2021 through July 2023 were included. Additional baseline information was obtained by retrospective review. The primary outcome was PROMIS Pain Intensity T-scores at 6 weeks, 3 months, and 6 months after RFA. The main predictor of interest was emotional distress, computed as average baseline PROMIS T-scores for depression and anxiety. Interaction terms tested how the influence of baseline emotional distress and pain intensity changed over the follow-up period.
Data were available for 154, 101, 91, and 83 participants at baseline, 6 weeks, 3 months, and 6 months post-RFA, respectively. Baseline emotional distress ( = 0.04) and baseline pain intensity ( = 0.01) were both associated with worse pain intensity at follow-up, controlling for each other. Interaction terms were not significant, though visual inspection of trends suggested that the influence of baseline emotional distress may increase as the follow-up period lengthens.
Patients reporting higher levels of baseline emotional distress experience less pain reduction after RFA, controlling for baseline pain intensity. Patients with greater emotional distress may benefit from treatments addressing emotional distress, in addition to or instead of RFA.
射频消融术（RFA）常用于治疗由小关节介导的颈椎、胸椎和腰椎疼痛。射频消融术缓解疼痛效果不佳可能是由于一些生物心理社会因素未通过该手术得到解决。
研究基线情绪困扰对射频消融术治疗反应的影响。
纳入2021年l月至2023年7月期间完成自我报告调查（患者报告结局测量系统，PROMIS）的患者。通过回顾性审查获取其他基线信息。主要结局是射频消融术后6周、3个月和6个月时的PROMIS疼痛强度T评分。主要的研究预测因素是情绪困扰，计算方法为抑郁和焦虑的平均基线PROMIS T评分。交互项检验了基线情绪困扰和疼痛强度的影响在随访期间如何变化。
分别有154、101、91和83名参与者在基线、射频消融术后6周、3个月和6个月时有可用数据。在相互控制的情况下，基线情绪困扰（P = 0.04）和基线疼痛强度（P = 0.01）均与随访时更严重的疼痛强度相关。交互项不显著，不过趋势的直观检查表明，随着随访期延长，基线情绪困扰的影响可能会增加。
在控制基线疼痛强度的情况下，报告基线情绪困扰水平较高的患者在射频消融术后疼痛减轻较少。除射频消融术之外或作为替代，情绪困扰较大的患者可能会从针对情绪困扰的治疗中受益。
