Utjecaj provokacijske diskografije na kirurško liječenje bolesnika s kroničnom križoboljom [Impact of provocative discography to surgical outcome in patients with chronic low back pain]

Margetić, Petra (2011) Utjecaj provokacijske diskografije na kirurško liječenje bolesnika s kroničnom križoboljom [Impact of provocative discography to surgical outcome in patients with chronic low back pain]. PhD thesis, Sveučilište u Zagrebu.

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Abstract

The objective of the study was comparison of surgical outcomes of patients operated on without discography and patients that underwent discography. According to power analysis study comprised 310 patients divided in the experimental (No=207) and the control (No=103) group. Inclusion criteria were low back pain resistant to the nonsurgical treatment for more than 6 months and conventional radiological findings showing degenerative changes without clear generator of the pain. Exclusion criteria were red flags. Before discography patients filled in Oswestry Disability Index (ODI), SFPF36, Zung and MSPGQ Questioners. In a control group of patients with DDD difference between preoperative and postoperative ODI were 22.07% or 11 points. In a group with discography in patients with DDD difference between preoperative and postoperative ODI were 35.04% or 17.5 points. In a control group of patients with stenosis difference between preoperative and postoperative ODI were 26.13% or 13 points. In a group with discography in patients with stenosis difference between preoperative and postoperative ODI were 28.42% or 14.5 points. Provocative discography screening with psychological testing in the trial group made improvement following fusion clinically significant. For other degenerative generators of the pain discography didn’t prove useful diagnostic tool.

Abstract in Croatian

Cilj ovog rada bio je usporediti rezultate kirurškog liječenja kod bolesnika nakon diskografije i bez diskografije. Prema rezultatu analize snage testa u studiju je uključeno 310 ispitanika koji su podijeljeni u ispitivanu (207) i kontrolnu (103) skupinu. Kriteriji uključivanja su bili križobolja koja 6 mjeseci ne reagira na nekirurško liječenje te dva ili više moguća generatora bola na MR. Kriteriji isključivanja su bili tumor, trauma, upala i trudnoća te ranije operacije lumbosakralne kralješnice. Prije diskografije ispitanici su ispunili Oswestry test, SFPF36, Zung i MSPQ test. Tijekom jednogodišnjeg postoperativnog praćenja ispunjavali su Oswestry, SFPF36, Likert skalu te su se morali izjasniti da li bi ponovo pristali na diskografiju. U kontrolnoj grupi u skupini DDD razlika predoperativnog i postoperativnog ODI iznosila je 22.07%, odnosno 11 bodova. U ispitivanoj grupi, u skupini DDD razlika predoperativnog i postoperativnog ODI iznosila je 35.04%, što je 17.5 bodova. U kontrolnoj grupi, u skupini stenoza razlika predoperativnog i postoperativnog ODI iznosila je 26,13% ili 13 bodova. U ispitivanoj grupi, u skupini stenoza razlika predoperativnog i postoperativnog ODI iznosila je 28,42% ili 14,5 bodova. Provokacijska diskografija uz psihološko testiranje statistički je značajno poboljšala rezultate kirurškog liječenja kod ispitanika sa degenerativnom bolesti diska.

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