Wilde Viktoria E, Ford Jon J, McMeeken Joan M
School of Physiotherapy, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Melbourne, Victoria 3010, Australia.
Phys Ther. 2007 Oct;87(10):1348-61. doi: 10.2522/ptj.20060329. Epub 2007 Aug 7.
The lumbar zygapophyseal joints (LZJs) are thought to be a source of low back pain (LBP); however, no valid or reliable indicators exist. The purpose of this study was to obtain a consensus from an expert panel on the indicators of LZJ pain.
A multidisciplinary panel of 20 experts in the field of LBP participated in this study.
A 3-round Delphi survey designed to obtain a consensus on the indicators of LZJ pain was completed by use of accepted protocols. Subjects also were asked to justify their selection of each indicator.
Following the 3 rounds, consensus was achieved, and 12 indicators were identified. Those that reached the highest levels of consensus were a positive response to facet joint injection, localized unilateral LBP, positive medial branch block, pain upon unilateral palpation of the LZJ or transverse process, lack of radicular features, pain eased by flexion, and pain, if referred, located above the knee. Justifications for the experts' selection of the indicators, predominantly based on pathoanatomical mechanisms, also were described.
This Delphi survey identified 12 indicators of LZJ pain, each with an associated pathoanatomical mechanism justifying selection. This survey provides preliminary validation for these indicators, which will be of value in further research into the classification and treatment of LZJ pain.
腰椎关节突关节（LZJs）被认为是腰痛（LBP）的一个来源；然而，目前尚无有效或可靠的指标。本研究的目的是就LZJ疼痛的指标达成专家小组共识。
一个由20名LBP领域多学科专家组成的小组参与了本研究。
采用公认的方案完成了一项三轮德尔菲调查，旨在就LZJ疼痛的指标达成共识。还要求受试者对其选择的每个指标说明理由。
经过三轮调查，达成了共识，并确定了12项指标。达成最高共识水平的指标有：对小关节注射呈阳性反应、局限性单侧腰痛、内侧支阻滞阳性、单侧触诊LZJ或横突时疼痛、无神经根症状、屈曲时疼痛缓解，以及若有牵涉痛则位于膝关节以上。还描述了专家选择这些指标的理由，主要基于病理解剖机制。
这项德尔菲调查确定了12项LZJ疼痛指标，每项指标都有相关的病理解剖机制作为选择依据。本调查为这些指标提供了初步验证，这将对进一步研究LZJ疼痛的分类和治疗具有价值。
