经椎间孔硬膜外类固醇注射治疗腰椎间盘突出症:与血清MicroRNA-155水平相关的疼痛强度和认知功能的影响。

IF 1.6 Q2 ANESTHESIOLOGY
Anesthesiology Research and Practice Pub Date : 2025-04-07 eCollection Date: 2025-01-01 DOI:10.1155/anrp/2201031
Wael Fathy, Mona Hussein, Rehab Magdy, Mona Nasser, Jehan Mohamed, Doaa Moaz Sayem, Hatem Elmoutaz, Nesma Mounir, Dina Mahmoud Fakhry, Mohamed Abdelbadie
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引用次数: 0

摘要

背景:腰椎间盘突出是致残性腰痛的常见原因。椎间盘突出或椎间盘突出在普通人群中的患病率随着年龄的增长而增加。目的:本研究旨在评估经椎间孔硬膜外类固醇注射(TFESI)对腰椎间盘突出症患者疼痛强度、认知功能和miR-155血清水平的影响。方法:本病例-对照研究对44例症状性腰椎间盘突出(L4-L5)患者和另外44例年龄和性别匹配的对照组进行了研究。采用数字评定量表(NRS)、Oswestry残疾指数(ODI)和功能评定指数(FRI)对患者的疼痛强度和功能障碍进行评估。分别在TFESI前和后1个月进行认知能力评估。对纳入的患者(TFESI前和1个月后)和对照组进行miR-155血清水平的估计。结果:TFESI后1个月患者的疼痛量表和认知测试得分均有统计学意义(p值≤0.05)。在TFESI后1个月,纳入的患者血清miRNA-155水平也有统计学意义的降低(p值< 0.001)。NRS变化的中位数为2 (1-4.75),ODI变化的中位数为18 (7-33),FRI变化的中位数为23.5 (12-31),PALT变化的中位数为1 (0-1.5),COWAT变化的中位数为2 (0.25-5),PASAT变化的中位数为3 (1.25-4),miRNA-155变化的中位数为0.555(0.16-0.738)。纳入患者血清miRNA-155水平与TFESI前所有疼痛和失能量表(NRS、ODI、FRI)评分及所有认知测试评分均有统计学意义(p值≤0.05)。结论:本研究强调了TFESI在腰椎间盘突出症中的表观遗传机制,导致miRNA-155显著下调,疼痛强度减轻,认知功能改善。试验注册:ClinicalTrials.gov标识符:NCT05626283。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Transforaminal Epidural Steroid Injection in Lumbar Disc Prolapse: Impact on Pain Intensity and Cognitive Function in Relation to MicroRNA-155 Serum Level.

Background: Lumbar disc prolapse is a common cause of disabling low back pain. The prevalence of disc prolapses or herniation in the general population increases with age. Objective: This work aimed to evaluate the impact of transforaminal epidural steroid injection (TFESI) in lumbar disc prolapse on pain intensity, cognitive function, and miR-155 serum level. Methods: The present case-control study was conducted on 44 patients with symptomatic lumbar disc prolapse (L4-L5) and another 44 age- and sex-matched controls. Assessment of the pain intensity and functional disability was done before and 1 month after TFESI using the numeric rating scale (NRS), Oswestry disability index (ODI), and functional rating index (FRI). Cognitive assessment was done before and 1 month after TFESI. Estimation of miR-155 serum level was done for the included patients (before and 1 month after TFESI) and controls. Results: There was a statistically significant improvement in pain scales and cognitive test scores 1 month following TFESI (p value ≤ 0.05 in all comparisons). There was also a statistically significant reduction in miRNA-155 serum level in the included patients one month following TFESI (p value < 0.001). The median values for the change in NRS were 2 (1-4.75), in ODI were 18 (7-33), in FRI were 23.5 (12-31), in PALT were 1 (0-1.5), in COWAT were 2 (0.25-5), in PASAT were 3 (1.25-4), and in miRNA-155 were 0.555 (0.16-0.738). There were statistically significant correlations between miRNA-155 serum levels in the included patients and the scores of all the pain and disability scales (NRS, ODI, and FRI) and the scores of all the cognitive tests before TFESI (p value ≤ 0.05 in all correlations). Conclusion: This study highlights the epigenetic mechanisms of TFESI in lumbar disc prolapse, causing significant downregulation of miRNA-155, reduced pain intensity, and improved cognitive function. Trial Registration: ClinicalTrials.gov identifier: NCT05626283.

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CiteScore
3.10
自引率
0.00%
发文量
29
审稿时长
18 weeks
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