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首页> 外文期刊>Journal of Pain Research >Treatment of a Large Cohort of Veterans Experiencing Musculoskeletal Disorders with Spinal Cord Stimulation in the Veterans Health Administration: Veteran Characteristics and Outcomes
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Treatment of a Large Cohort of Veterans Experiencing Musculoskeletal Disorders with Spinal Cord Stimulation in the Veterans Health Administration: Veteran Characteristics and Outcomes

机译：在退伍军人卫生管理局中处理肌肉骨骼疾病的大型退伍军人队列，脊髓刺激：退伍军人特征和结果

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Objective: Spinal cord stimulator (SCS) implantation is used to treat chronic pain, including painful musculoskeletal disorders (MSDs). This study examined the characteristics and outcomes of veterans receiving SCSs in Veterans Health Administration (VHA) facilities. Methods: The sample was drawn from the MSD Cohort and limited to three MSDs with the highest number of implants (N=815,475). There were 1490 veterans with these conditions who received SCS implants from 2000 to 2012, of which 95% (n=1414) had pain intensity numeric rating scale (NRS) data both pre- and post-implant. Results: Veterans who were 35– 44 years old, White, and married reported higher pain NRS ratings, had comorbid inclusion diagnoses, had no medical comorbidities, had a BMI 25– 29.9, or had a depressive disorder diagnosis were more likely to receive an SCS. Veterans 55+ years old or with an alcohol or substance use disorder were less likely to receive an SCS. Over 90% of those receiving an SCS were prescribed opioids in the year prior to implant. Veterans who had a presurgical pain score ≥ 4 had a clinically meaningful decrease in their pain score in the year following their 90-day recovery period (Day 91– 456) greater than expected by chance alone. Similarly, there was a significant decrease in the percent of veterans receiving opioid therapy (92.4% vs 86.6%, p 0.0001) and a significant overall decrease in opioid dose [morphine equivalent dose per day (MEDD) =26.48 vs MEDD=22.59, p 0.0003]. Conclusion: Results offer evidence of benefit for some veterans with the examined conditions. Given known risks of opioid therapy, the reduction is an important potential benefit of SCS implants.
机译：目的：脊髓刺激器（SCS）植入用于治疗慢性疼痛，包括痛苦的肌肉骨骼障碍（MSDS）。本研究检测了退伍军人在退伍军人健康管理局（VHA）设施中获得SCSS的特点和结果。方法：样品从MSD队列中抽出并限制在植入物数量最多的三个MSDS（n = 815,475）。有1490名退伍军人，这些条件接受了2000〜2012年的SCS植入物，其中95％（n = 1414）具有止痛强度数值级（NRS）数据，包括植入后和植入后。结果：35-44岁，白人和已婚的退伍军人报告疼痛的NRS评分较高，患有了合并包容性诊断，没有医疗合并症，患有BMI 25-29.9，或抑郁症诊断更有可能接受SCS。 5岁以上或酒精或物质使用障碍的退伍军人不太可能接受SCS。在植入前的年份，超过90％的接受SCS的人在植物前一年进行。具有预先疼痛评分的退伍军人≥4在其90天恢复期（第91-456天）之后的一年中的疼痛评分比偶然的预期临床上的临床有意义的降低。同样，接受阿片类药物治疗的退伍军人百分比的显着降低（92.4％，P <0.0001）和阿片类药物的显着整体减少[均每天吗啡（MEDD）= 26.48 VS Medd = 22.59， P <0.0003]。结论：结果为某些退伍军人提供了有益的证据。鉴于阿片类药物治疗的已知风险，减少是SCS植入物的重要潜在益处。

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