周围神经场刺激治疗背部手术失败综合征腰痛的随机对照试验

Randomized controlled trial of peripheral nerve field stimulation in the treatment of low back pain in patients with failed back surgery syndrome

目的探讨周围神经场刺激(peripheral nerve field stimulation,PNFS)治疗背部手术失败综合征(failed back surgery syndrome,FBSS)腰痛的临床效果。方法选择2017年9月~2019年11月在本院就诊的38例FBSS患者作为研究对象,采用随机数字表法分为对照组和观察组各19例。对照组给予脊髓刺激(spinal cord stimulation,SCS)治疗,观察组在SCS治疗的基础上给予PNFS治疗。观察两组患者治疗过程中的并发症发生率,统计两组治疗前、治疗第3个月、第6个月时的腰痛VAS评分、腿痛VAS评分和ODI指数、欧洲生活质量五维量表(five dimensional scale of quality of life in Europe,EQ-5D)评分。结果治疗3个月、6个月时,两组腰痛VAS、腿痛VAS评分和ODI指数均较治疗前显著降低(P<0.05),观察组患者腰痛VAS、ODI低于同期对照组(P<0.05)。治疗3个月、6个月时,两组患者EQ-5D评分均较治疗前显著升高(P<0.05),且观察组EQ-5D评分显著高于对照组(P<0.05)。结论SCS联合PNFS治疗FBSS可改善患者的腰部疼痛程度,减轻其功能障碍,提高整体生活质量。

Objective To investigate the clinical effect of peripheral nerve field stimulation(PNFS)in the treatment of low back pain caused by failed back surgery syndrome(FBSS).Methods From September 2017 to November 2019,38 FBSS patients who treated in our hospital were selected in this study.The patients were divided into control group and observation group with random number table method,with 19 cases in each group.The control group was treated with spinal cord stimulation(SCS),and the observation group was treated with PNFS on the basis of SCS.The incidence of complications in the two groups was observed.The VAS scale,VAS in legs,Oswestry disability index(ODI)and five dimensional scale of quality of life in Europe(EQ-5 D)in the two groups were counted before treatment,at the 3 rd and 6 th month of treatment.Results After treatment for 3 and 6 months,the VAS,ODI of lumbago in the two groups were significantly lower than before treatment(P<0.05),and the VAS and ODI of lumbago in the observation group were lower than those in the control group(P<0.05).After treatment for 3 and 6 months,EQ-5 D in both two groups was significantly higher than before treatment(P<0.05),and EQ-5 D in the observation group was higher than that in the control group(P<0.05).Conclusion SCS combined with PNFS in the treatment of FBSS can improve the degree of lumbar pain,reduce the degree of dysfunction,and improve the overall quality of life.