Does therapist's attitude affect clinical outcome of lumbar facet joint injections?

作     者：Marcus Middendorp Konstantinos Kollias Hanns Ackermann Annina Splettstoβer Thomas J Vogl M Fawad Khan Adel Maataoui 

作者机构：Department of Nuclear MedicineGoethe University Institute for Diagnostic and Interventional RadiologyGoethe University Institute of Biostatistics and Mathematical ModelingGoethe University radprax MVZ 

出 版 物：《World Journal of Radiology》 (世界放射学杂志（英文版）（电子版）)

年 卷 期：2016年第8卷第6期

页      面：628-634页

学科分类：0831[工学-生物医学工程（可授工学、理学、医学学位）] 100207[医学-影像医学与核医学] 1002[医学-临床医学] 100210[医学-外科学(含：普外、骨外、泌尿外、胸心外、神外、整形、烧伤、野战外)] 08[工学] 1010[医学-医学技术（可授医学、理学学位）] 10[医学] 

主　　题：Facet joint injection Hetero-suggestion Low back pain Lumbar spine Magnetic resonance imaging Facet joint osteoarthritis 

摘      要：AIM: To investigate if the clinical outcome of intraarticular lumbar facet joint injections is affected by the therapist s attitude. METHODS: A total of 40 patients with facet jointassociated chronic low back pain were randomly divided into two groups. All patients received computed tomography-guided, monosegmental intra-articular facet joint injections. Following the therapeutic procedure, the patients of the experimental group(EG) held a conversation with the radiologist in a comfortable atmosphere. During the dialog, the patients were encouraged to ask questions and were shown four images. The patients of the control group(CG) left the clinic without any further contact with the radiologist. Outcome was assessed using a pain-based Verbal Numeric Scale at baseline, at 1 wk and at 1, 3, and 6 mo after first treatment. RESULTS: The patient demographics showed no differences between the groups. The patients of the EG received 57 interventional procedures in total, while the patients of the CG received 70 interventional procedures. In both groups, the pain scores decreased significantly over the entire observation period. Compared to the CG, the EG showed a statistically significant reduction of pain at 1 wk and 1 mo post-treatment, while at 3 and 6 mo after treatment, there were no significant differences between both groups. CONCLUSION: Our results show a significant effect on pain relief during the early post-interventional period in the EG as compared to the CG. The basic principle behind the higher efficacy might be the phenomenon of hetero-suggestion.