Fulltext

Lumbar nerve root injections: a prospective cohort outcomes study comparing age- and gender-matched patients who returned an outcomes-based postal questionnaire with patients who did not return the postal questionnaire

Lechmann, Marco ; Peterson, Cynthia ; Pfirrmann, Christian ; Hodler, Jürg

In: Skeletal Radiology, 2013, vol. 42, no. 10, p. 1429-1435

Add to personal list
    Title
    • Lumbar nerve root injections: a prospective cohort outcomes study comparing age- and gender-matched patients who returned an outcomes-based postal questionnaire with patients who did not return the postal questionnaire
    Author
    • Lechmann, Marco. Department of Radiology, Orthopaedic University Hospital of Balgrist, Forchstrasse 340, 8008, Zurich, Switzerland
    • Peterson, Cynthia. Department of Radiology, Orthopaedic University Hospital of Balgrist, Forchstrasse 340, 8008, Zurich, Switzerland
    • Pfirrmann, Christian. Department of Radiology, Orthopaedic University Hospital of Balgrist, Forchstrasse 340, 8008, Zurich, Switzerland
    • Hodler, Jürg. Department of Radiology, University Hospital, Rämistrasse 100, 8091, Zurich, Switzerland
    Document Type
    • Postprint
    OAI-PMH Identifier
    • oai:doc.rero.ch:310531
    Summary
    Objective: The purpose of this study is to investigate if relying on postal questionnaires returned by patients provides an accurate representation of reported outcomes from patients receiving imaging-guided lumbar nerve root injections (NRIs). Materials and methods: Patients who received imaging-guided transforaminal lumbar NRIs were given short questionnaires inquiring about pain level [numerical rating scale (NRS)] and overall improvement [Patient's Global Impression of Change (PGIC)]. Those who did not return the questionnaires (non-responders) were telephoned and asked about pain level and overall change in condition. Age and gender matching of responders and non-responders resulted in 97 patients in each group. The proportion of patients reporting clinically relevant "improvement” or "worsening” in each group was calculated and the Chi-square test was used to detect differences. NRS and PGIC scores for responders and non-responders were compared using Student's ttest and the Mann-Whitney U test, respectively. Results: A higher proportion of non-responders reported clinically relevant improvement (53.6%) compared to responders (42.6%) and responders reported significantly higher levels of worsening of condition (p = 0.01). Both responders and non-responders had significant (p ≤ 0.05) improvement on the 20-30-min and 1-month NRS scores compared to their pre-injection baseline scores. Non-responders had significantly higher baseline NRS scores but no significant difference at the 20-30-min and 1-month NRS scores compared to responders. Conclusions: Patients returning postal questionnaires reported less favorable outcomes compared to those who did not return their questionnaires