脊柱退化的严重程度不会影响在持续的外周止痛下减轻疼痛
Vincent J Heck1,2, Bastian Himpe3,4, Juan M Vinas-Rios5,6
1Orthopedic University Hospital Friedrichsheim, University Hospital of Frankfurt, Marienburgstrasse 2, 60528, Frankfurt, Germany. vincent.heck@uk-koeln.de.
概括
持续的外周止痛疗法 (CEA) 显著减少了背部手术失败综合征 (FBSS) 和腰椎缩 (LSS) 的患者的疼痛. 然而,神经系统缺陷和严重残疾可能表明不太有利的结果.
科学领域:
- 疼痛管理 疼痛管理
- 神经外科 神经外科
- 康复医学 康复医学 康复医学
背景情况:
- 背部手术失败综合征 (FBSS) 和腰椎狭窄症 (LSS) 是慢性腰部疼痛的常见原因.
- 有效的疼痛管理策略对于改善患者的功能和生活质量至关重要.
研究的目的:
- 评估在患有FBSS或LSS的患者中持续外周止痛 (CEA) 的临床有效性.
- 评估脊柱退行症严重程度对CEA结果的影响.
主要方法:
- 在住院康复期间接受CEA的148名患者的回顾性队列研究.
- 通过视觉模拟量表 (VAS) 每小时测量疼痛减轻;实质性减轻定义为>50% (MCID).
- 记录了脊柱退化,副作用和患者的特征.
主要成果:
- 无论是FBSS还是LSS组,均显示出显著的平均疼痛减轻 (约. 分别为-37.6和-38.1).
- 在FBSS中感官缺陷/麻木,在LSS中严重残疾 (ODI) 与更糟糕的结果有关.
- 脊柱退行症的严重程度和心理障碍没有影响实现MCID的疼痛减轻.
结论:
- 对于FBSS和LSS患者来说,CEA提供了显著的疼痛缓解,即使是严重的退化和并发症.
- 神经学缺陷 (FBSS) 和严重残疾 (LSS) 是CEA结果低于最佳的潜在风险因素.
- 在选定的患者群体中,CEA是慢性腰部疼痛的可行治疗选择.
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