Psychosocial Stress Reactivity as Predictor of Operative Outcome in Lumbar Disc Surgery
Psychosocial Stress Reactivity as Predictor of Operative Outcome in Lumbar Disc Surgery
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DOI：
10.1016/j.wneu.2019.05.180
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发表时间：
2019-09-01
影响因子：
2
通讯作者：
Leimert, Mario
中科院分区：
文献类型：
--
作者：
Petrowskit, Katja;Ritzka, Desiree;Leimert, Mario
背景：很大一部分人患有慢性背痛。对于最佳治疗，问题是哪些患者会从保守治疗中受益，哪些患者最适合腰椎间盘手术。这似乎是合理的分析的影响，临床参数的操作结果，以确定患者将受益较少，从手术或需要特殊的术前/术后medications.MATERIALS和方法：从2012年3月至2014年7月，32例患者进行了治疗，通过显微镜支持椎板间开窗和椎间盘切除术在神经外科，德累斯顿大学医院卡尔古斯塔夫卡鲁斯。手术前一天，在特里尔社会压力测试的压力反应期间进行皮质醇调查。与此同时，进行了相关问卷调查，其中术后症状的经验是可操作的，并与相同的信息30天后的评价进行比较after.RESULTS：它可以表明，皮质醇反应性和疼痛负担手术后之间存在联系。在应激暴露下皮质醇反应较大的患者部分经历了比皮质醇反应较低的患者更强烈的术后疼痛。然而，这种关系只能解释由单一的显着结果，而进一步的计算不能产生任何significance.CONCLUSIONS：皮质醇反应性似乎与疼痛的发展。与本研究结果不一致的是，术后疼痛与皮质醇反应性之间存在复杂的相关性，这需要进一步研究。
BACKGROUND: A large proportion of the population suffers from chronic back pain. For optimal treatment, the question arises which patients would benefit from conservative therapy and for whom lumbar disc surgery is most appropriate. It seems reasonable to analyze the impact of paraclinical parameters on the operation outcome to identify patients who would benefit less from surgery or need special pre-/postoperative medical care.MATERIALS AND METHODS: From March 2012 to July 2014, 32 patients were treated via microscopically supported interlaminar fenestration and discectomy at the Department of Neurosurgery, University Hospital Carl Gustav Carus Dresden. One day before the operation, a cortisol survey was made during the stress response of the Trier Social Stress Test. At the same time, a survey of relevant questionnaires was conducted by which the postoperative symptom experience was made operational and comparable with the evaluation of the same information thirty days afterwards.RESULTS: It could be shown that there is a connection between cortisol reactivity and the pain burden following operations. Patients with a greater cortisol reaction under stress exposition partially experienced more intense postoperative pain than the patients with a lower cortisol reaction. However, this relationship could only be explained by single significant results, whereas further calculations could not produce any significance.CONCLUSIONS: Cortisol reactivity seems to be associated with pain development. The inconsistent findings in empiricism as well as in this investigation are indicative of a complex association of postoperative pain and cortisol reactivity, which needs to be examined further.