PDF(Pubmed)
Abstract：
OBJECTIVE: Selective nerve root blocks (SNRB) are used both as a therapeutic and diagnostic tool for lumbar radicular pain. Most studies evaluate the effect of SNRB simply by its relation to pain reduction. It is well known that pain is associated with other factors such as depression, anxiety, inactivity and sleeping disorders, but these patient-related outcomes are seldom evaluated. This study evaluated the influence of SNRB on pain-related outcomes including depression, anxiety, fatigue, pain interference, activity and sleep.
METHODS: One hundred three patients with lumbar radicular pain were treated with a SNRB. Patient-reported outcome measures (PROMs) were assessed with the PROMIS-29 for 12 weeks (84 days) following the SNRB. Patients were stratified based on their pain reduction at the 14-day follow up as responders (≥ 30% pain reduction) and non-responders (< 30% pain reduction). Post-treatment duration was estimated with the Kaplan-Meier analysis with return to baseline as an event. A paired t-test was used to compare pre- and post-treatment responses at specific time intervals.
RESULTS: Forty-four percent (n = 45) of the patients were responders and showed significant improvement in all parameters throughout the 84-days follow-up, the exception was sleep that lost significance at day 70. The mean post-treatment duration among responders was 59 (52-67) days. Non-responders showed significant improvements in pain interference and pain intensity until day 35 and in ability for social participation until 21-day.
CONCLUSIONS: SNRB can improve pain intensity, pain interference, physical function, fatigue, anxiety, depression, sleep disturbance and the ability to participate in social roles.
METHODS: One hundred three patients with lumbar radicular pain were treated with a SNRB. Patient-reported outcome measures (PROMs) were assessed with the PROMIS-29 for 12 weeks (84 days) following the SNRB. Patients were stratified based on their pain reduction at the 14-day follow up as responders (≥ 30% pain reduction) and non-responders (< 30% pain reduction). Post-treatment duration was estimated with the Kaplan-Meier analysis with return to baseline as an event. A paired t-test was used to compare pre- and post-treatment responses at specific time intervals.
RESULTS: Forty-four percent (n = 45) of the patients were responders and showed significant improvement in all parameters throughout the 84-days follow-up, the exception was sleep that lost significance at day 70. The mean post-treatment duration among responders was 59 (52-67) days. Non-responders showed significant improvements in pain interference and pain intensity until day 35 and in ability for social participation until 21-day.
CONCLUSIONS: SNRB can improve pain intensity, pain interference, physical function, fatigue, anxiety, depression, sleep disturbance and the ability to participate in social roles.
摘要：
目的：选择性神经根阻滞（SNRB）可作为腰椎神经根性疼痛的治疗和诊断工具。大多数研究仅通过其与疼痛减轻的关系来评估SNRB的效果。众所周知，疼痛与抑郁等其他因素有关，焦虑,不活动和睡眠障碍，但这些与患者相关的结局很少被评估.这项研究评估了SNRB对疼痛相关结果的影响，包括抑郁症。焦虑,疲劳,疼痛干扰，活动和睡眠。
方法：用SNRB治疗130例腰椎神经根性疼痛患者。SNRB后12周(84天)用PROMIS-29评估患者报告的结果测量(PROMs)。在14天的随访中，根据患者的疼痛减轻情况将患者分层为响应者（疼痛减轻≥30％）和非响应者（疼痛减轻<30％）。使用Kaplan-Meier分析估计治疗后持续时间,其中返回基线作为事件。使用配对t检验以特定的时间间隔比较治疗前和治疗后的反应。
结果：44％（n=45）的患者是应答者，在整个84天的随访中，所有参数均有显着改善。唯一的例外是在第70天失去意义的睡眠。应答者的平均治疗后持续时间为59(52-67)天。无反应者在第35天之前的疼痛干扰和疼痛强度以及在21天之前的社会参与能力方面显示出显着改善。
结论：SNRB可以改善疼痛强度，疼痛干扰，物理功能，疲劳,焦虑,抑郁症,睡眠障碍和参与社会角色的能力。
方法：用SNRB治疗130例腰椎神经根性疼痛患者。SNRB后12周(84天)用PROMIS-29评估患者报告的结果测量(PROMs)。在14天的随访中，根据患者的疼痛减轻情况将患者分层为响应者（疼痛减轻≥30％）和非响应者（疼痛减轻<30％）。使用Kaplan-Meier分析估计治疗后持续时间,其中返回基线作为事件。使用配对t检验以特定的时间间隔比较治疗前和治疗后的反应。
结果：44％（n=45）的患者是应答者，在整个84天的随访中，所有参数均有显着改善。唯一的例外是在第70天失去意义的睡眠。应答者的平均治疗后持续时间为59(52-67)天。无反应者在第35天之前的疼痛干扰和疼痛强度以及在21天之前的社会参与能力方面显示出显着改善。
结论：SNRB可以改善疼痛强度，疼痛干扰，物理功能，疲劳,焦虑,抑郁症,睡眠障碍和参与社会角色的能力。
