补充髓核异体移植治疗腰椎间盘源性疼痛的耐久性。

IF 2.5 3区 医学 Q2 CLINICAL NEUROLOGY
Journal of Pain Research Pub Date : 2025-04-09 eCollection Date: 2025-01-01 DOI:10.2147/JPR.S516571
Shrif Costandi, Douglas P Beall, Timothy T Davis, Kasra Amirdelfan, Ramana K Naidu, Michael J DePalma, Edward S Yoon, Jacob W Fleming, Jon E Block, Nagy Mekhail
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引用次数: 0

摘要

背景:本研究的目的是确定椎间盘内植入异基因髓核(NP)治疗慢性轴性腰痛患者的腰椎间盘源性疼痛严重程度和相关背部损伤的改善程度,这种治疗可达到两个椎体水平(L1-S1)。方法:在美国6个地点进行前瞻性单臂临床研究,涉及28名椎间盘源性疼痛患者(平均年龄:44±13岁),磁共振成像改良Pfirrmann分级3-7。本报告包括手术后24个月的最终参与者随访。采用11分数字评定量表(NRS)评估背部疼痛严重程度,采用Oswestry残疾指数(ODI)评估背部功能。最小临床重要差异(MCID)和实质性临床获益(SCB)分别设定为基线≥30%和≥50%。患者可接受症状状态(PASS)疼痛严重程度阈值≤3。结果:24个月后,腰痛严重程度的平均改善为43%,从基线时的7.1±1.6改善到3.6±2.9。结论:本研究通过24个月的随访,为腰椎间盘源性疼痛患者单次异体NP补充手术后的临床显著疼痛缓解和功能改善提供了证据。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Durability of Supplemental Nucleus Pulposus Allograft in Patients with Lumbar Discogenic Pain.

Background: The objective of this study was to determine the degree of improvement in lumbar discogenic pain severity and associated back impairment in patients with chronic axial low back pain treated with intradiscally delivered allogeneic nucleus pulposus (NP) at up to two vertebral levels (L1-S1).

Methods: Prospective, single-arm clinical study conducted at 6 sites in the US involving 28 participants with discogenic pain (mean age: 44 ± 13 yrs) and modified Pfirrmann grade 3-7 on magnetic resonance imaging. This report includes the final participant follow up at 24 months post procedure. Back pain severity was evaluated using an 11-point numeric rating scale (NRS) and back function using the Oswestry Disability Index (ODI). Minimal clinically important difference (MCID) and substantial clinical benefit (SCB) were set at ≥30% and ≥50% over baseline, respectively. The patient acceptable symptom state (PASS) threshold for pain severity was ≤3.

Results: The average improvement in back pain severity from 7.1 ± 1.6 at baseline to 3.6 ± 2.9 at 24 months was 43% (p<0.001). Approximately 64% (14 of 22) of participants achieved both the MCID and SCB in back pain at 24 months, while nearly 55% (12 of 22) reported a 24-month back pain severity score of ≤3. The corresponding average decrease in ODI values was 53% (p<0.001) with 73% (16 of 22) of participants achieving the MCID. At baseline approximately 82% (23 of 28) of participants reported severe or crippled back impairment compared to 18% (4 of 22) at 24 months (p<0.001). There was no association between modified Pfirrmann grade, number of levels treated or Modic changes and any outcome (range: p=0.12 to 0.43).

Conclusion: This study provides evidence of clinically significant pain relief and functional improvement through 24 months of follow up after a single allogeneic NP supplementation procedure in patients with lumbar discogenic pain.

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来源期刊
Journal of Pain Research
Journal of Pain Research CLINICAL NEUROLOGY-
CiteScore
4.50
自引率
3.70%
发文量
411
审稿时长
16 weeks
期刊介绍: Journal of Pain Research is an international, peer-reviewed, open access journal that welcomes laboratory and clinical findings in the fields of pain research and the prevention and management of pain. Original research, reviews, symposium reports, hypothesis formation and commentaries are all considered for publication. Additionally, the journal now welcomes the submission of pain-policy-related editorials and commentaries, particularly in regard to ethical, regulatory, forensic, and other legal issues in pain medicine, and to the education of pain practitioners and researchers.
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