Risk Factors for Persistent Pain and Disability in Acute to Subacute Sciatica Caused by Lumbar Disk Herniation After Epidural Injections

DOI Web Site Web Site 参考文献25件
  • MORITA YOSHIHITO
    Department of Anesthesiology and Pain Medicine, Juntendo University Faculty of Medicine
  • ISEKI MASAKO
    Department of Anesthesiology and Pain Medicine, Juntendo University Faculty of Medicine
  • YONEZAWA IKUHO
    Department of Orthopedic Surgery, Juntendo University Faculty of Medicine
  • NAKAHARA DAISHI
    Department of Orthopedic Surgery, Juntendo University Faculty of Medicine
  • SAKOTA JUNTA
    Department of Orthopedic Surgery, Juntendo University Faculty of Medicine
  • DOI TOKUHIDE
    Fukuoka Clinic
  • IFUKU MASATAJA
    Department of Anesthesiology and Pain Medicine, Juntendo University Faculty of Medicine
  • NAKAO AKIRA
    Nakao Clinic
  • NAKAMURA YOSHITAKA
    Department of Anesthesiology and Pain Medicine, Juntendo University Faculty of Medicine
  • INADA EIICHI
    Department of Anesthesiology and Pain Medicine, Juntendo University Faculty of Medicine

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Purpose: Identifying prospective predictors of a poor treatment outcome in acute to subacute sciatica would be of great importance for clinical practice. This study aimed to determine what baseline factors are associated with short- to medium-term outcomes on acute to subacute sciatica caused by lumbar disk herniation (LDH) after epidural injections. Methods: Variables including demographic data, neurological and radiological examination, the visual analog scale (VAS), the Roland-Morris Disability Questionnaire (RMDQ), and the Spielberger State-Trait Anxiety Inventory from 48 LDH patients (25 males and 23 females between 20 and 60 years old) with acute to subacute sciatica before and 1, 3, and 6 months following epidural injections were measured. A poor outcome was defined as a VAS reduction of less than 50% or a RMDQ reduction of less than an important change. Results: In multiple logistic regression analysis, the presence of a high trait anxiety (OR=0.133, 95% CI;0.027-0.651) and motor disturbances (OR=3.517, 95% CI;1.098-11.267) were significantly associated with an increasing risk of poor outcome at the 1-month assessment. At the 3-month assessment, the presence of a high trait anxiety (OR=0.115, 95% CI;0.022-0.611) was the only prognostic factor. At the 6-month assessment, the presence of a high trait anxiety (OR=0.065, 95% CI;0.007-0.570) was the only significant prognostic factor.

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