退行性宫肌病减压后的慢性疼痛:对个人参与者数据的综合轨迹分析
Alex B Bak1, Ali Moghaddamjou2,3, Paul M Arnold4,5
1Department of Anesthesiology and Pain Medicine, University of Toronto, Toronto, ON, Canada.
Pain
|October 14, 2025
概括
退行性宫髓病 (DCM) 的疼痛轨迹有很大的不同. 虽然手术通常可以减轻疼痛,但36.1%的患者在24个月后也会经历慢性疼痛.
科学领域:
- 神经外科 神经外科
- 整形外科 整形外科 整形外科
- 疼痛医学 医学 疼痛医学
背景情况:
- 退行性宫髓病 (DCM) 显著影响生活质量,慢性疼痛是一个主要问题.
- 对DCM患者的长期疼痛轨迹和影响因素的了解仍然很少.
- 了解这些疼痛模式对于有效的患者管理和治疗策略至关重要.
研究的目的:
- 在手术后的DCM患者中识别和描述不同的疼痛轨迹.
- 调查与DCM中慢性疼痛的发展和持续相关的因素.
- 提供有关疼痛不同临床过程的患者亚群的见解.
主要方法:
- 使用了来自AO脊柱CSM-北美,CSM-国际和CSM-Protect研究的协调数据集.
- 预期收集的部残疾指数疼痛强度 (NDI-PI) 在手术前和手术后的6,12和24个月.
- 采用隐性类轨迹建模,根据NDI-PI得分将患者分类为不同的疼痛路径.
主要成果:
- 在952名患者中,32%的患者患有严重的手术前疼痛,29.1%的患者患有中度疼痛,38.9%的患者患有最小疼痛.
- 手术后的病历有所不同:严重疼痛患者的病情完全消失 (42.0%),中度恢复 (34.4%),或边际恢复 (23.6%).
- 在24个月后,所有患者中有36.1%的患者经历了慢性疼痛,这表明在一个显著的子集中存在持续的疼痛问题.
结论:
- 在DCM中,手术前疼痛的严重程度定义了不同的患者亚群,具有不同的术后疼痛过程.
- 在许多DCM患者中,手术干预与长期疼痛减轻有关.
- 很大一部分DCM患者在手术后继续经历慢性疼痛,这凸显了进一步研究和有针对性的干预措施的必要性.
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