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首页> 外文期刊>Journal of manipulative and physiological therapeutics: JMPT >Symptomatic magnetic resonance imaging-confirmed lumbar disk herniation patients: A comparative effectiveness prospective observational study of 2 age- and sex-matched cohorts treated with either high-velocity, low-amplitude spinal manipulative therapy or imaging-guided lumbar nerve root injections
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Symptomatic magnetic resonance imaging-confirmed lumbar disk herniation patients: A comparative effectiveness prospective observational study of 2 age- and sex-matched cohorts treated with either high-velocity, low-amplitude spinal manipulative therapy or imaging-guided lumbar nerve root injections

机译：有症状的磁共振成像确认的腰椎间盘突出症患者：一项针对两组年龄和性别相匹配的队列的比较有效性的前瞻性观察性研究，这些队列均接受了高速，低幅脊椎手法治疗或影像引导的腰神经根注射治疗

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Objectives The purpose of this study was to compare self-reported pain and "improvement" of patients with symptomatic, magnetic resonance imaging-confirmed, lumbar disk herniations treated with either high-velocity, low-amplitude spinal manipulative therapy (SMT) or nerve root injections (NRI). Methods This prospective cohort comparative effectiveness study included 102 age- and sex-matched patients treated with either NRI or SMT. Numerical rating scale (NRS) pain data were collected before treatment. One month after treatment, current NRS pain levels and overall improvement assessed using the Patient Global Impression of Change scale were recorded. The proportion of patients, "improved" or "worse," was calculated for each treatment. Comparison of pretreatment and 1-month NRS scores used the paired t test. Numerical rating scale and NRS change scores for the 2 groups were compared using the unpaired t test. The groups were also compared for "improvement" using the χ2 test. Odds ratios with 95% confidence intervals were calculated. Average direct procedure costs for each treatment were calculated. Results No significant differences for self-reported pain or improvement were found between the 2 groups. "Improvement" was reported in 76.5% of SMT patients and in 62.7% of the NRI group. Both groups reported significantly reduced NRS scores at 1 month (P =.0001). Average cost for treatment with SMT was Swiss Francs 533.77 (US $558.75) and Swiss Francs 697 (US $729.61) for NRI. Conclusions Most SMT and NRI patients with radicular low back pain and magnetic resonance imaging-confirmed disk herniation matching symptomatic presentation reported significant and clinically relevant reduction in self-reported pain level and increased global perception of improvement. There were no significant differences in outcomes between NRI and SMT. When considering direct procedure costs, the average cost of SMT was slightly less expensive.
机译：目的这项研究的目的是比较经症状，经磁共振成像确认，腰椎间盘突出症的患者采用高速，低幅脊柱手法治疗（SMT）或神经根后的自我报告的疼痛和“改善”情况注射剂（NRI）。方法这项前瞻性队列比较有效性研究包括102名接受NRI或SMT治疗的年龄和性别匹配的患者。在治疗前收集数字评分量表（NRS）疼痛数据。治疗后一个月，记录当前的NRS疼痛水平和使用“患者总体变化印象”量表评估的总体改善情况。计算每种治疗的“改善”或“较差”的患者比例。使用配对t检验比较预处理和1个月NRS评分。使用不配对t检验比较两组的数字评分量表和NRS变化评分。还使用χ2检验比较了各组的“改善”。计算出置信区间为95％的几率。计算每种治疗的平均直接手术费用。结果两组之间自我报告的疼痛或改善无明显差异。据报道，有76.5％的SMT患者和62.7％的NRI组“改善”。两组均报告在1个月时NRS得分显着降低（P = .0001）。 NRI的平均治疗费用为533.77瑞士法郎（558.75美元）和697瑞士法郎（729.61美元）。结论大多数SMT和NRI伴有放射神经性下腰痛并经磁共振成像确诊的椎间盘突出症伴有症状的患者，其自我报告的疼痛水平显着降低且在临床上具有相关意义，并且对改善的整体感觉有所提高。 NRI和SMT之间的结局无显着差异。考虑直接过程成本时，SMT的平均成本略低。

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