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DOI: 10.1055/s-0031-1280121
© Georg Thieme Verlag KG Stuttgart · New York
Effekte der Kernspinresonanztherapie auf Krankenstand bei Patienten mit Nervenwurzelirritation infolge eines lumbalen Bandscheibenvorfalls
Impact of Magnetic Resonance Therapy on Sickness Absence of Patients with Nerve Root Irritation Following a Lumbar Disc ProblemPublication History
Publication Date:
07 October 2011 (online)
![](https://www.thieme-connect.de/media/zfo/201105/lookinside/thumbnails/10.1055-s-0031-1280121-1.jpg)
Zusammenfassung
Hintergrund: Rückenbeschwerden haben in den westlichen Industrienationen eine Prävalenz von bis zu 80 %. Rückenschmerzen sind die zweithäufigste Ursache für einen Arztbesuch. Die verursachten Kosten für das Gesundheitswesen sind proportional zum subjektiv erlebten Schmerz. Ziel dieser Studie war es festzustellen, ob sich durch die Anwendung von Kernspinresonanztherapie der Krankenstand bei Patienten mit diskogener Radikulopathie verändert. Patienten und Methode: Die Anwendung von Kernspinresonanztherapie auf Rückenschmerz bei diskogener Radikulopathie wurde doppelblind, prospektiv randomisiert, gesundheitsökonomisch evaluiert. Patienten im Alter von 20 bis 55 Jahren mit Lumboischialgie ohne Indikation zur chirurgischen Intervention wurden eingeschlossen. Die Zahl der Krankenstandstage in einer Versuchsgruppe vor und nach Magnetfeldtherapie und in einer Kontrollgruppe wurde 2‐fach erhoben. Die Krankenstandstage wurden mittels Schmerztagebuch und mittels telefonischer Rückfrage ermittelt. Ergebnisse: Jene Patienten, die mit eingeschalteter Kernspinresonanztherapieanlage behandelt wurden, hatten signifikant weniger Krankenstandstage (p = 0,009), wenn diese mittels direkter, persönlicher, telefonischer Rücksprache ermittelt wurden. Der Krankenstand vor Therapie betrug 14,7 Tage, nach Therapie 5,8 Tage. Im Gegensatz dazu ließ sich der Krankenstand der Kontrollgruppe vor Therapie mit 7,6 Tagen und nach Therapie mit 13,8 Tagen errechnen. Die Dauer der Beschwerden zeigte einen negativen Zusammenhang mit den Krankenstandstagen. Bei Angabe einer beruflichen Belastung wurden signifikant mehr Krankenstandstage (8,3 Tage) in Anspruch genommen als ohne berufliche Belastung (3,2 Tage). Diese Korrelation besteht jedoch nicht bei einer familiären Belastung. Die Kosteneffektivitätsanalyse ergab eine Kompensation der direkten Kosten für die Kernspinresonanztherapie in unterschiedlichem Ausmaß je nach Berufsgruppe. Für Arbeiter kompensierten 16,9 Tage, für Angestellte 11,4 Tage und für Beamte 9,1 Tage weniger Krankenstand die direkten und indirekten Kosten der Kernspinresonanztherapie. Schlussfolgerung: Die Studie konnte durch Messung der Krankenstandstage bestätigen, dass durch eine relativ billige alternative Technik eine Schmerzlinderung und damit auch ein gesundheitsökonomischer Nutzen erzielt werden können. Problematisch sind Patienten, die sich in Arbeitslosigkeit oder in einem laufenden Rentenverfahren befinden, weil sie womöglich nicht gesundgeschrieben werden wollen.
Abstract
Background: The prevalence of spinal symptoms in Western industrialised countries ranges up to 80 %. Back pain ranks second among the most common reasons to seek medical advice. The resulting financial burden on the health-care system is proportional to the subjectively experienced pain. The aim of the present study was to determine whether the use of magnetic resonance therapy alters the duration of sickness absence in patients with discogenic radiculopathy. Patients and Method: In a double-blind prospective randomised study, the use of magnetic resonance therapy for back pain in patients with discogenic radiculopathy was evaluated in the context of health economics. Patients aged 20 to 55 years with lumboischialgia and no indication for surgery were included in the study. The primary variable was the number of days of sickness absence in a study group before and after magnetic field therapy, and in a control group. The number of days of sickness absence was determined on the basis of a pain diary and by telephone inquiry. Results: Patients who were treated with an activated magnetic resonance therapy device had significantly fewer days of sickness absence (p = 0.009) when evaluated by personal telephone calls. The duration of sickness absence before therapy was 14.7 days and that after therapy 5.8 days. In contrast, the days of sickness absence in the control group were 7.6 days before therapy and 13.8 days after therapy. The duration of symptoms was negatively correlated with the days of sickness absence. Patients who reported a burden at work had more days of sickness absence (8.3 days) than those with no burden at work (3.2 days). This correlation does not apply to familial burden. The cost-effectiveness analysis showed different degrees of compensation of the cost of magnetic resonance therapy, depending on the occupational group. Direct and indirect costs of magnetic resonance therapy were compensated by 16.9 fewer days of sickness absence among workers, 11.4 fewer days of sickness absence among employees, and 9.1 fewer days of sickness absence among civil servants. Conclusion: Based on the number of days of sickness absence, the study confirmed that a relatively economical alternative technique is able to provide pain relief as well as benefit the health economy. Unemployed patients or patients who have submitted an application for a pension may be problematic because they may not wish to be pronounced healthy by their doctors.
Schlüsselwörter
Rückenschmerz - Kernspinresonanztherapie - Krankenstand
Key words
back pain - magnetic resonance therapy - sickness absence
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Dr. Gabriele Salomonowitz, MAS, MBA
Radiologietechnologie
FH-Campus Wien
Favoritenstraße 226
1100 Wien
Österreich
Phone: +43/6 99 11 71 35 89
Fax: +43/16 06 68 77 48 09
Email: gabriele.salomonowitz@fh-campuswien.ac.at