LOW-BACK-PAIN PATIENTS UNRESPONSIVE TO AN EPIDURAL STEROID INJECTION - IDENTIFYING PREDICTIVE FACTORS
LOW-BACK-PAIN PATIENTS UNRESPONSIVE TO AN EPIDURAL STEROID INJECTION - IDENTIFYING PREDICTIVE FACTORS
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DOI：
10.1097/00002508-199112000-00010
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发表时间：
1991-01-01
影响因子：
2.9
通讯作者：
FERRANTE, FM
中科院分区：
文献类型：
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作者：
JAMISON, RN;VADEBONCOUER, T;FERRANTE, FM
这项研究探讨了有助于识别腰痛患者是否无法从腰椎硬膜外类固醇注射 (LESI) 中获益的因素。 249 名慢性腰痛患者在接受 LESI 之前、之后 1 天和之后 2 周评估了他们的疼痛强度。所有患者在治疗前均完成了全面的疼痛调查问卷和简要症状调查表（BSI）。诊断和病理范围由两名医生独立评估。 131 名患者（52.6%）在治疗后 1 年进行了随访。结果显示，接受 LESI 两周后，62.3% 的患者平均疼痛强度等级下降。治疗一年后，62.6% 的人认为 LESI 有帮助。九名患者（7%）认为治疗有害。确定了 LESI 术后 2 周后最能预测不良结果的四个因素：(a) 之前接受的疼痛治疗次数较多； (b) 服用更多药物； (c) 疼痛不一定会因活动而加剧，以及 (d) 疼痛会因咳嗽而加剧。预测治疗 1 年后不会获益的因素包括 (a) 疼痛不影响活动； (b) 因疼痛而失业； (c) 治疗前的正常直腿抬高测试； (d) 药物不能减轻疼痛。
This study examined factors that help to identify low back pain patients who do not benefit from a lumbar epidural steroid injection (LESI). Two-hundred and forty-nine chronic low back pain patients assessed their pain intensity before, 1 day after, and 2 weeks after receiving a LESI. All patients completed a comprehensive pain questionnaire and a Brief Symptom Inventory (BSI) prior to treatment. Diagnosis and extent of pathology were independently assessed by two physicians. One-hundred and thirty-one patients (52.6%) were followed 1 year after treatment. Results showed that average pain intensity ratings decreased in 62.3% of patients 2 weeks after receiving a LESI. One year after treatment, 62.6% felt that LESI was helpful. Nine patients (7%) felt that the treatment was harmful. Four factors were identified that best predicted poor outcome 2 weeks after LESI: (a) greater number of previous treatments for pain; (b) more medications taken; (c) pain not necessarily increased by activities, and (d) pain increased by coughing. Factors that predicted no benefit 1 year after treatment included (a) pain does not interfere with activities; (b) unemployment due to pain; (c) normal straight-leg raise test prior to treatment; and (d) pain not decreased by medication.