Article
Psychological parameters and their influence on outcome measures of peripheral nerve field stimulation (PNFS) in chronic low back pain
Psychologische Faktoren und deren Einfluss auf Outcome-Parameter nach peripherer Nervenfeldstimulation (PNFS) bei Patienten mit chronischer Lumbago
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Published: | June 4, 2021 |
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Objective: PNFS is effective in patients with chronic low back pain. As the treatment of low back pain strongly depends on psychological factors, this study evaluates the impact of such factors on outcome measures after lead- and neurostimulatorimplantation.
Methods: Between 2014 and 2019 a prospective cohort study of 40 patients with chronic lumbar pain was conducted. Symptom checklist-90 (SCL-90) measured the subjective psychopathology. Hospital Anxiety and Depression Scale (HADS) score was assessed at baseline to measure symptoms of anxiety and depression. Pain intensity (NRS), SF12v2 with Physical Component Summary (PCS) and Mental Component Summary (MCS) scores, and Oswestry Disability Index (ODI) were assessed pre- and postoperatively as well as 3 and 6 months after PFNS implantation. All outcome values were compared to baseline data. Statistical analysis was performed using depending t-test and analysis of variance (ANOVA). A p-value <0.05 was considered significant.
Results: The cohort consisted of 40 patients (19 females, 21 males) with a median age of 60.5 years (IQR25-75 52-67 years). NRS, ODI, and SF12v2 showed significant improvement in the whole follow up period compared to baseline values (p<0.05). Elevated HADS scores for anxiety were seen in 64%, for depression in 77% of the patients at baseline. SCL-90 was pathologic in 72% of the cases. A one-way ANOVA revealed no differences between elevated HADS- and SCL-90 values and all outcome measures after PNFS implantation in the whole follow up period (p>0.05).
Conclusion: Chronic low back pain is often associated with mental health problems. Highly elevated levels for anxiety and depression as well as subjective mental stress in patients with chronic low back pain had no negative impact on NRS, ODI, and SF12v2 in the whole follow up after PNFS implantation.