Predictors of outcome in fusion surgery for chronic low back pain.: A report from the Swedish Lumbar Spine Study
Predictors of outcome in fusion surgery for chronic low back pain.: A report from the Swedish Lumbar Spine Study
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DOI：
10.1007/s00586-002-0465-z
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发表时间：
2003-02-01
影响因子：
2.8
通讯作者：
Nordwall, A
中科院分区：
文献类型：
--
作者：
Hägg, O;Fritzell, P;Nordwall, A
尽管手术技术和植入物不断发展，但仍有相当数量的患者因慢性腰痛（CLBP）接受手术，但没有任何益处，甚至变得更糟。为了寻找功能和工作状态结果的预测因素，264例长期严重CLBP患者随机接受手术或非手术治疗，其特征在于社会人口统计学，临床，放射学和心理变量。这些变量被估计为2年随访结果的预测因子。在两个治疗组中使用单变量和多元logistic回归分析。我们发现，低神经质和低椎间盘高度的人格特征是手术治疗后功能改善的重要预测因素。非手术治疗后抑郁症状预示功能改善。手术组的低年龄和短病假预测了工作恢复，而非手术组的短病假预测了工作恢复。我们的结论是，改善选择成功的手术候选人与CLBP似乎是促进重视严重的椎间盘退变，人格特质的评价和缩短术前病假。
Despite the continuous development of surgical techniques and implants, a substantial number of patients still undergo surgery for chronic low back pain (CLBP) without any benefit, or even become worse. With the aim of finding predictors of functional and work status outcome, 264 patients with severe CLBP of long duration, randomised to surgical or non-surgical treatment, were characterized by socio-demographic, clinical, radiological and psychological variables. The variables were estimated as predictors of outcome at the 2-year follow-up. Univariate and multiple logistic regression analyses were used in both treatment groups. We found that a personality characterized by low neuroticism and low disc height were significant predictors of functional improvement after surgical treatment. Depressive symptoms predicted functional improvement after non-surgical treatment. Work resumption was predicted by low age and short sick leave in the surgical group, and by short sick leave in the non-surgical group. We conclude that improved selection of successful surgical candidates with CLBP seems to be promoted by attention to severe disc degeneration, evaluation of personality traits and shortening of preoperative sick leave.