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How Does Anxiety and Depression Affect the Outcome after Periradicular Infiltration Therapy?—A Retrospective Analysis of Patients Undergoing CT-Guided Single-Level Nerve Root Infiltration Due to Chronic Monoradicular Pain

The aim of this study was to research the influence of psychological confounders on patient-reported outcomes (PROs) after lumbar infiltration therapies of periradicular infiltrations (PRI). Patients who underwent PRI in a single center between June 2018 and December 2019 were included. PRI was perf...

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Autores principales: Lindemann, Chris, Hölzl, Alexander, Böhle, Sabrina, Zippelius, Timo, Strube, Patrick
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10527802/
https://www.ncbi.nlm.nih.gov/pubmed/37761249
http://dx.doi.org/10.3390/diagnostics13182882
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author Lindemann, Chris
Hölzl, Alexander
Böhle, Sabrina
Zippelius, Timo
Strube, Patrick
author_facet Lindemann, Chris
Hölzl, Alexander
Böhle, Sabrina
Zippelius, Timo
Strube, Patrick
author_sort Lindemann, Chris
collection PubMed
description The aim of this study was to research the influence of psychological confounders on patient-reported outcomes (PROs) after lumbar infiltration therapies of periradicular infiltrations (PRI). Patients who underwent PRI in a single center between June 2018 and December 2019 were included. PRI was performed in patients with predominantly unilateral lumbar radiculopathy which existed for at least 6 weeks based on single-level nerve root compression (caused by a herniated disc, stenosis of the lateral recess, or neuroforamen), confirmed by morphological imaging. The numeric pain rating scale (NRS) for back pain (BP) and leg pain (LP) and the Oswestry Disability Index (ODI) were assessed preinterventionally, on the first day (only NRS) and at 6 weeks, and then 3, 6, and 12 months postinterventionally. The minimally clinically important difference (MCID) served as the threshold for the therapeutic effectiveness evaluation. The health-related quality of life (SF-36) was recorded preinterventionally and after 12 months. Based on the Hospital Anxiety and Depression Scale, the patients were dichotomized into depressed or nondepressed and anxious or nonanxious. Categorical data were evaluated using Fisher’s exact test, and continuous data were evaluated using Student’s t test. Separate linear mixed models were built to estimate the effect of anxiety or depression on repeatedly measured PROs following PRI. Data were analyzed using SPSS software. The analysis included 102 patients. Most mean baseline PROs were significantly worse in anxious or depressed patients than in nonanxious or nondepressed patients: Anxiety NRS-BP (p = 0.007), ODI (p < 0.001); Depression NRS-BP (p = 0.026), NRS-LP (p < 0.001), ODI (p < 0.001). All patients showed a clinically meaningful reduction in pain and functional improvement over a 12-month follow-up. There was no significant difference in the estimated overall mean PRO between all patients (p > 0.05). In conclusion, anxiety and depression are associated with worse PROs before and after PRI. However, patients with underlying depression or anxiety can expect a similar gain in PRO compared to patients without depressive or anxious symptoms.
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spelling pubmed-105278022023-09-28 How Does Anxiety and Depression Affect the Outcome after Periradicular Infiltration Therapy?—A Retrospective Analysis of Patients Undergoing CT-Guided Single-Level Nerve Root Infiltration Due to Chronic Monoradicular Pain Lindemann, Chris Hölzl, Alexander Böhle, Sabrina Zippelius, Timo Strube, Patrick Diagnostics (Basel) Article The aim of this study was to research the influence of psychological confounders on patient-reported outcomes (PROs) after lumbar infiltration therapies of periradicular infiltrations (PRI). Patients who underwent PRI in a single center between June 2018 and December 2019 were included. PRI was performed in patients with predominantly unilateral lumbar radiculopathy which existed for at least 6 weeks based on single-level nerve root compression (caused by a herniated disc, stenosis of the lateral recess, or neuroforamen), confirmed by morphological imaging. The numeric pain rating scale (NRS) for back pain (BP) and leg pain (LP) and the Oswestry Disability Index (ODI) were assessed preinterventionally, on the first day (only NRS) and at 6 weeks, and then 3, 6, and 12 months postinterventionally. The minimally clinically important difference (MCID) served as the threshold for the therapeutic effectiveness evaluation. The health-related quality of life (SF-36) was recorded preinterventionally and after 12 months. Based on the Hospital Anxiety and Depression Scale, the patients were dichotomized into depressed or nondepressed and anxious or nonanxious. Categorical data were evaluated using Fisher’s exact test, and continuous data were evaluated using Student’s t test. Separate linear mixed models were built to estimate the effect of anxiety or depression on repeatedly measured PROs following PRI. Data were analyzed using SPSS software. The analysis included 102 patients. Most mean baseline PROs were significantly worse in anxious or depressed patients than in nonanxious or nondepressed patients: Anxiety NRS-BP (p = 0.007), ODI (p < 0.001); Depression NRS-BP (p = 0.026), NRS-LP (p < 0.001), ODI (p < 0.001). All patients showed a clinically meaningful reduction in pain and functional improvement over a 12-month follow-up. There was no significant difference in the estimated overall mean PRO between all patients (p > 0.05). In conclusion, anxiety and depression are associated with worse PROs before and after PRI. However, patients with underlying depression or anxiety can expect a similar gain in PRO compared to patients without depressive or anxious symptoms. MDPI 2023-09-08 /pmc/articles/PMC10527802/ /pubmed/37761249 http://dx.doi.org/10.3390/diagnostics13182882 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Lindemann, Chris
Hölzl, Alexander
Böhle, Sabrina
Zippelius, Timo
Strube, Patrick
How Does Anxiety and Depression Affect the Outcome after Periradicular Infiltration Therapy?—A Retrospective Analysis of Patients Undergoing CT-Guided Single-Level Nerve Root Infiltration Due to Chronic Monoradicular Pain
title How Does Anxiety and Depression Affect the Outcome after Periradicular Infiltration Therapy?—A Retrospective Analysis of Patients Undergoing CT-Guided Single-Level Nerve Root Infiltration Due to Chronic Monoradicular Pain
title_full How Does Anxiety and Depression Affect the Outcome after Periradicular Infiltration Therapy?—A Retrospective Analysis of Patients Undergoing CT-Guided Single-Level Nerve Root Infiltration Due to Chronic Monoradicular Pain
title_fullStr How Does Anxiety and Depression Affect the Outcome after Periradicular Infiltration Therapy?—A Retrospective Analysis of Patients Undergoing CT-Guided Single-Level Nerve Root Infiltration Due to Chronic Monoradicular Pain
title_full_unstemmed How Does Anxiety and Depression Affect the Outcome after Periradicular Infiltration Therapy?—A Retrospective Analysis of Patients Undergoing CT-Guided Single-Level Nerve Root Infiltration Due to Chronic Monoradicular Pain
title_short How Does Anxiety and Depression Affect the Outcome after Periradicular Infiltration Therapy?—A Retrospective Analysis of Patients Undergoing CT-Guided Single-Level Nerve Root Infiltration Due to Chronic Monoradicular Pain
title_sort how does anxiety and depression affect the outcome after periradicular infiltration therapy?—a retrospective analysis of patients undergoing ct-guided single-level nerve root infiltration due to chronic monoradicular pain
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10527802/
https://www.ncbi.nlm.nih.gov/pubmed/37761249
http://dx.doi.org/10.3390/diagnostics13182882
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