单独使用微创性减压的结果与用于主导背部疼痛的融合
Pratyush Shahi1, Tejas Subramanian1,2, Omri Maayan1,2
1Hospital for Special Surgery, New York, NY, USA.
概括
与融合相比,仅用于背部疼痛的最小侵入性减压显示出类似的整体改善和患者满意度,但在某些措施中实现最小临床重要差异的比例较低.
科学领域:
- 脊柱手术的结果 脊柱手术的结果
- 最少侵入性的脊柱手术是最少侵入性的.
- 比较有效性研究比较有效性研究
背景情况:
- 之前关于单独减压治疗背部疼痛的研究缺乏比较的融合数据.
- 确定优化手术策略对于主导的背痛至关重要.
研究的目的:
- 为了比较单独的微创性减压与在患有主要背部疼痛的患者中融合的结果.
- 评估患者报告的结果指标 (PROM),临床重要差异最小值 (MCID),患者可接受的症状状态 (PASS) 和全球评级变化 (GRC).
主要方法:
- 在510名患有手术前背部疼痛>腿部疼痛的患者进行了回顾性队列研究.
- 使用PROM,MCID,PASS和GRC进行评估的结果.
- 对手术前背部疼痛<腿部疼痛.患者的亚组分析.
主要成果:
- 解压和融合都在<6个月和>6个月显示出显著的PROM改善,大小没有差异.
- 融合组在VAS背部疼痛 (<6个月) 和ODI (>6个月) 方面获得了更高的MCID.
- 两组之间没有观察到PASS或GRC的显著差异.
结论:
- 仅仅微创性减压就导致了较低的MCID成就率,针对特定的疼痛和残疾措施,与主要背部疼痛患者的融合相比.
- 尽管如此,除压力单独提供了显著的整体PROM改善,类似的患者满意度 (PASS) 和类似的感知恢复 (GRC).
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