Burchiel K J, Anderson V C, Wilson B J, Denison D B, Olson K A, Shatin D
Division of Neurosurgery, Oregon Health Sciences University, Portland, USA.
Neurosurgery. 1995 Jun;36(6):1101-10; discussion 1110-1. doi: 10.1227/00006123-199506000-00006.
Spinal cord stimulation (SCS) has been used for more than 20 years in the treatment of diverse pain conditions. Although recent studies have identified more clearly those conditions for which SCSoffers a favorable prognosis, the identification of a patient population in whom reasonably long-term success can be expected has been difficult. In an effort to improve patient selection and increase the overall success rate of treatment, we have examined various physical, demographic, and psychosocial variables as predictors of SCS outcome. The study population consisted of 40 patients with chronic low back and/or leg pain, 85% of whom were diagnosed with failed back surgery syndrome. Medical history and demographic data were collected as part of an initial assessment along with patient responses to the Minnesota Multiphasic Personality Inventory, the visual analogue pain rating scale (VAS), the McGill Pain Questionnaire, the Oswestry Disability Questionnaire, the Beck Depression Inventory, and the Sickness Impact Profile. Treatment outcomes were examined and found to improve significantly after 3 months of stimulation. Subsequent regression analysis revealed that patient age, the Minnesota Multiphasic Personality Inventory depression subscale D, and the evaluative subscale of the McGill Pain Questionnaire (MPQe) were important predictors of posttreatment pain status. Increased patient age and D subscale scores correlated negatively with pain status, as measured by the percentage of changes in pretreatment and posttreatment VAS scores, % delta VAS. In contrast, higher MPQe correlated with improved pain status. By the use of the following equation and the definition commonly associated with SCS success (at least 50% decrease in the VAS pain level), the success or failure of 3 months of SCS was correctly predicted in 88% of the study population. Our results suggest that patient age, Minnesota Multiphasic Personality Inventory depression, and MPQe may be clinically useful in the prediction of pain status after 3 months of SCS in patients with chronic low back and/or leg pain. % delta VAS = 112.57 - 1.98 (D)-1.68 (Age) + 35.54 (MPQe).
脊髓刺激（SCS）已用于治疗多种疼痛病症20多年。尽管最近的研究更明确地确定了哪些病症SCS预后良好，但确定有望获得合理长期成功的患者群体一直很困难。为了改进患者选择并提高总体治疗成功率，我们研究了各种身体、人口统计学和社会心理变量，作为SCS结果的预测指标。研究人群包括40例慢性腰腿痛患者，其中85%被诊断为腰椎手术失败综合征。收集病史和人口统计学数据作为初始评估的一部分，同时收集患者对明尼苏达多相人格调查表、视觉模拟疼痛评分量表（VAS）、麦吉尔疼痛问卷、奥斯威斯利残疾问卷、贝克抑郁量表和疾病影响概况的回答。检查治疗结果，发现刺激3个月后有显著改善。随后的回归分析显示，患者年龄、明尼苏达多相人格调查表抑郁分量表D以及麦吉尔疼痛问卷（MPQe）的评估分量表是治疗后疼痛状态的重要预测指标。患者年龄增加和D分量表得分与疼痛状态呈负相关，以治疗前和治疗后VAS评分变化百分比（%delta VAS）衡量。相比之下，较高的MPQe与改善的疼痛状态相关。通过使用以下方程以及通常与SCS成功相关的定义（VAS疼痛水平至少降低50%），在88%的研究人群中正确预测了3个月SCS的成功或失败。我们的结果表明，患者年龄、明尼苏达多相人格调查表抑郁以及MPQe在预测慢性腰腿痛患者SCS 3个月后的疼痛状态方面可能具有临床实用性。%delta VAS = 112.57 - 1.98（D）-1.68（年龄）+ 35.54（MPQe）
