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dc.contributor.authorMåwe, Leif
dc.contributor.authorThorén, Lena Måwe
dc.contributor.authorKvarstein, Gunnvald
dc.date.accessioned2021-09-09T09:12:22Z
dc.date.available2021-09-09T09:12:22Z
dc.date.issued2020-01-24
dc.description.abstractIntroduction - There is limited evidence for effect of interventional treatment, and pragmatic studies are needed to assess these interventions within a clinical setting. The aim of this study was to describe patients referred to an interventional pain clinic and investigate responses after spinal intervention in general and for radiofrequency ablation (RFA) and transforaminal epidural corticosteroid administration (TECA), specifically. <p> <p>Methods - This is a prospective, non-controlled study of patients with chronic spinal pain. The procedures were performed in accordance with the Spine Intervention Society recommendations. Outcome data after a median of 4.5 months are presented, and for those treated with RFA also after 6 and 12 months. <p> <p>Results - Among 815 patients, 190 patients underwent diagnostic blocks only and 625 interventional treatment, of these 94 RFA and 246 TECA. Of the whole sample 70% reported pain reduction, for 49% ≥ 50%, while 9% were pain free (p < 0.001). Highest pain intensity decreased from 7.1 to 5.4 [95% Confidence Interval of the Difference (95%-CI): 1.4–1.9] (p < 0.001), while Euroqual – visual analogue scale for general health (EQ-VAS) improved from 48 to 58 (95%-CI: 7.6–11.9) (p < 0.001), and Euroqual-5 Dimensions-5 Levels Index for health related quality of life (EQ-5D-5L Index) from 0.489 to 0.628 (95%-CI: 0.123–0.157) (p < 0.001). The proportions, not taking analgesics, increased from 16% to 30%, and proportion taking strong opioids decreased from 14% to 9% (p < 0.001). We found no significant change in proportion receiving physiotherapy/other treatment nor occupational status. No complications were reported. Among patients treated with RFA, 77% reported pain reduction, for 56% ≥ 50%, while 9% were pain free (p < 0.001). Highest pain intensity decreased from 6.9 to 4.6 (95%-CI: 1.6–3.0) (p < 0.001), while EQ-VAS improved from 47 to 57 (95%-CI: 4.8–13.6 (p < 0.001), and EQ-5D-5L Index from 0.489 to 0.643 (95%-CI: 0.117–0.191) (p < 0.001). The proportion not taking analgesics, increased from 7% to 23% and proportion taking strong opioids decreased from 16% to 10%. Among patients who responded at 6- and 12-month follow up, the proportions reporting pain reduction, EQ-VAS, and EQ-5D-5L Index remained significantly improved from baseline, and the change in proportions taking analgesic and opioids achieved statistical significance. We found no significant change in proportion receiving physiotherapy/other treatment nor occupational status. Among patients treated with TECA, 58% reported pain reduction, for 36% ≥ 50%, while 5% were pain free (p < 0.001). Highest pain intensity decreased from 7.2 to 6.2 (95%-CI 0.5–1.4) (p < 0.001), while EQ-VAS improved from 46 to 52 (95%-CI: 2.0–3.6) (p < 0.001), and EQ-5D-5L Index from 0.456 to 0.571 (95%-CI: 0.077–0.138) (p < 0.001). The proportions, not taking analgesics, increased from 17% to 27% and proportion taking strong opioids decreased from 15% to 10%, but the changes did not reach statistical significance. We found no significant changes in the proportion who recieved physiotherapy/other treatment nor occupational status. <p> <p>Conclusion - The study demonstrates substantial short-term responses after spinal intervention and long-lasting improvement for a subsample of the RFA treated patients. We observed larger proportions reporting pain reduction among those treated with cervical RFA. <p> <p>Implementation - Quality assessment should be implemented in interventional pain clinics to improve treatment quality.en_US
dc.identifier.citationMåwe L, Thorén, Kvarstein G. Responses after spinal interventions in a clinical pain practice - A pragmatic observational study. Scandinavian Journal of Pain. 2020:1-14en_US
dc.identifier.cristinIDFRIDAID 1812437
dc.identifier.doi10.1515/sjpain-2019-0126
dc.identifier.issn1877-8860
dc.identifier.issn1877-8879
dc.identifier.urihttps://hdl.handle.net/10037/22474
dc.language.isoengen_US
dc.publisherDe Gruyteren_US
dc.relation.journalScandinavian Journal of Pain
dc.rights.accessRightsopenAccessen_US
dc.rights.holder© 2020 Scandinavian Association for the Study of Pain. Published by Walter de Gruyter GmbH, Berlin/Boston. All rights reserveden_US
dc.subjectVDP::Medical disciplines: 700en_US
dc.subjectVDP::Medisinske Fag: 700en_US
dc.titleResponses after spinal interventions in a clinical pain practice - A pragmatic observational studyen_US
dc.type.versionacceptedVersionen_US
dc.typeJournal articleen_US
dc.typeTidsskriftartikkelen_US
dc.typePeer revieweden_US


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