Yellow flag on prognostic factors for non-specific chronic low back pain patients subjected to mini-invasive treatment: a cohort study

• Published in: European spine journal Vol. 29; no. 8; pp. 1879 - 1886
• Main Authors: Zackova, Monica, Aspide, Raffaele, Braghittoni, Anita, Zenesini, Corrado, Palandri, Giorgio
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01.08.2020; Springer Nature B.V
• Subjects: Analgesics; Back pain; Cohort analysis; Drug resistance; Low back pain; Medicine; Medicine & Public Health; Mental depression; Neurosurgery; Original Article; Quality of life; Surgical Orthopedics; Health-related quality of life; Physical component scale; Pain management; Chronic low back pain; Drug resistance; Mental component scale; SF-36
• ISSN: 0940-6719; 1432-0932; 1432-0932
• DOI: 10.1007/s00586-020-06475-8

Objectives Research was conducted to study the efficacy of analgesic infiltration treatment in a well-selected population of patients with non-specific drug-resistant chronic low back pain. It studied the pain on a numeric rating scale and the physical and mental condition of patients using a short-form health survey-36, before and six months after invasive pain treatment. Design This is a prospective observational single center cohort study. Setting The study took place in the Multimodal Pain Therapy Unit of the IRCCS Institute of Neurological Sciences in Bologna, Italy. Subjects Four hundred and thirteen out of a total 538 patients admitted to the unit with non-specific drug-resistant chronic low back pain were enrolled in the study. Method Patients were enrolled with written consent between April 2017 and November 2018. The study assessed NRS, BDI and SF-36 scores before and six months after mini-invasive treatment. Results There is an inverse correlation between Mental Component Scale (MCS) and Physical component scale as measured by SF-36. Older patients in a worse physical condition but with a more positive outlook on their quality of life were more likely to improve after invasive treatment ( p  < 0.001). The BDI scale is more effective in the diagnosis of depression than MCS. Conclusions The prognostic value of MCS given to the patient before mini-invasive treatment could lead physicians to adopt a multimodal approach that includes consideration of the psychological features of pain and possibly antidepressant therapy.