Martin G
N Z Med J. 1978 Mar 22;87(608):208-11.
An analysis of the carefully taken histories of 68 patients whose disc lesion was verified at operation showed that 72% of them gave a history of trauma at the onset of backache. The forces involved varied from very great to minimal and 28% had no history of trauma at all. Therefore it is concluded that trauma may be a precipitating but not a primary factor. It is suggested that the primary factor is a painless nuclear herniation into the inner layers of the annulus, which are painless because they have no innervation. Trauma causes the nucleus to rupture into or through the outer five or so innervated layers, precipitating pain and symptoms.
对68例经手术证实存在椎间盘病变患者的详细病史分析表明，其中72%的患者在背痛发作时有外伤史。所涉及的外力大小不一，从非常大到极小，28%的患者根本没有外伤史。因此得出结论，外伤可能是一个促发因素，但不是主要因素。有人认为主要因素是无痛的髓核疝入纤维环内层，因为内层没有神经支配所以无痛。外伤导致髓核破裂进入或穿过外侧约五层有神经支配的纤维环，从而引发疼痛和症状。
