JBJS:戒烟可减轻腰背痛患者的疼痛
2012-12-11 JBJS: JBJS:
许多研究表明吸烟与腰痛、腰椎间盘突出症、患者术后预后不良的风险增加具有关。骨与关节外科杂志（JBJS）2012年12月发表的一项最新研究还发现，患脊柱疾病和相关腰背部疼痛的吸烟者，与在8个月治疗期停止吸烟的脊柱疾病患者相比，不适感更为显著。 几乎所有的成年人都可能在某段时间内因背部疼痛或其
许多研究表明吸烟与腰痛、腰椎间盘突出症、患者术后预后不良的风险增加具有关。骨与关节外科杂志（JBJS）2012年12月发表的一项最新研究还发现，患脊柱疾病和相关腰背部疼痛的吸烟者，与在8个月治疗期停止吸烟的脊柱疾病患者相比，不适感更为显著。
几乎所有的成年人都可能在某段时间内因背部疼痛或其他疼痛性脊柱疾患而就诊。吸烟已被确定为慢性疼痛性疾病一个可改变的危险因素，因此研究人员回顾了8个月内5300多例接受手术或非手术治疗的腰背部或腿部神经根性疼痛的脊柱疾病患者的吸烟史并监测患者自我报告的疼痛情况。
在进入研究时，从未吸烟者和已戒烟患者疼痛明显比目前吸烟者和在研究期间戒烟的患者更轻。当前吸烟患者在（VAS）疼痛评分报告最差，当前和平均每周疼痛评分均显示，目前吸烟者较从未吸烟者疼痛更严重。
其他主要调查结果：
治疗过程中戒烟的患者与继续吸烟者相比，背部疼痛改善更显著。
非吸烟者VAS疼痛评分平均改善具有临床显著性。
治疗过程中继续吸烟患者报告的疼痛无临床显著性改善。
从未吸烟者与目前吸烟者相比，Oswestry功能障碍指数（腰背疼痛评估最常用的测量指标）的平均改善更显著。
“我们知道，尼古丁可使疼痛加剧，该项研究发现，如果在治疗过程中戒烟，预后更好；如果继续吸烟，无论接受何种治疗均不能显著改善疼痛症状。如果吸烟，则手术或非手术改善症状的可能性会显著下降。”罗切斯特大学骨科Glenn R. Rechtine博士说。“这项研究发现疼痛性脊柱疾病患者的疼痛改善与戒烟之间存在强相关，腰背痛患者有必要戒烟。”
Background:
Smoking is associated with low back pain, intervertebral disc disease, inferior patient outcomes following surgical interventions, and increased rates of postoperative complications. The purpose of the present study was to examine the effect of smoking and smoking cessation on pain and disability in patients with painful spinal disorders.
Methods:
We examined a prospectively maintained database of records for 5333 patients with axial or radicular pain from a spinal disorder with regard to smoking history and the patient assessment of pain on four visual analog scales during the course of care. Confounding factors, including secondary gain, sex, age, and body mass index, were also examined. The mean duration of follow-up was eight months. Multivariate statistical analysis was performed with variables including smoking status, secondary gain status, sex, depression, and age as predictors of pain and disability.
Results:
Compared with patients who had never smoked, patients who were current smokers reported significantly greater pain in all visual analog scale pain ratings (p < 0.001). The mean improvement in reported pain over the course of care was significantly different between nonsmokers and current smokers (p <0.001). Compared with patients who had continued to smoke, those who had quit smoking during the course of care reported significantly greater improvement in pain in visual analog scale pain ratings for worst (p = 0.013), current (p < 0.05), and average weekly pain (p = 0.024). The mean improvement in the visual analog scale pain ratings was clinically important in patients in all three groups of nonsmokers. As a group, those who had continued smoking during treatment had no clinically important improvement in reported pain.
Conclusions:
Given a strong association between improved patient-reported pain and smoking cessation, this study supports the need for smoking cessation programs for patients with a painful spinal disorder.
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本网站所有内容来源注明为“梅斯医学”或“MedSci原创”的文字、图片和音视频资料，版权均属于梅斯医学所有。非经授权，任何媒体、网站或个人不得转载，授权转载时须注明来源为“梅斯医学”。其它来源的文章系转载文章，或“梅斯号”自媒体发布的文章，仅系出于传递更多信息之目的，本站仅负责审核内容合规，其内容不代表本站立场，本站不负责内容的准确性和版权。如果存在侵权、或不希望被转载的媒体或个人可与我们联系，我们将立即进行删除处理。
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好文章，是不是以后门诊也可以这么建议腰背痛患者
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#背痛#
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#腰背痛#
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#JBJS#
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