Peng Bao-Gan, Wu Wen-Wen, Kuang Zheng-da, Li Zhen-Zhou, Guo Ji-Dong, Hou Shu-Xun
Department of Spinal Surgery, General Hospital of Armed Police Force, Beijing, China.
Zhonghua Wai Ke Za Zhi. 2007 Oct 15;45(20):1401-4.
To explore the methods of diagnosis and surgical treatment for patients with back pain originating from endplate.
All patients received examinations of radiography, CT, and MR imaging. Pain level of disc was decided by discography in each patient. The principal outcome judgment were pain and disability, and the efficacy of surgical treatment was assessed by visual analog scale (VAS) for pain, and the Oswestry disability index (ODI) for functional recovery.
All patients with a diagnosis of back pain originating from endplate according to discography were treated with anterior or posterior fusion surgery. The mean follow-up period was three years and five months (from 2 to 6 years). Among of the 21 patients, 20 (95%) reported a disappearance or marked alleviation of low back pain, and experienced a definite improvement in physical function. A statistically significant and clinically meaningful improvement on the ODI and the VAS scores were obtained in the patients with chronic low back pain originating from endplate (P = 0.0001) after treatment.
The study suggests that the discography and fusion surgery may be very effective methods for the diagnosis and treatment of chronic back pain originating from endplate respectively.
探讨终板源性背痛患者的诊断及手术治疗方法。
所有患者均接受了X线、CT及磁共振成像检查。通过椎间盘造影确定每位患者的椎间盘疼痛程度。主要结局判断指标为疼痛和功能障碍，采用视觉模拟评分法（VAS）评估手术治疗的疼痛疗效，采用Oswestry功能障碍指数（ODI）评估功能恢复情况。
根据椎间盘造影诊断为终板源性背痛的所有患者均接受了前路或后路融合手术。平均随访时间为3年零5个月（2至6年）。21例患者中，20例（95%）报告下腰痛消失或明显减轻，身体功能有明确改善。终板源性慢性下腰痛患者治疗后ODI和VAS评分有统计学意义且具有临床意义的改善（P = 0.0001）。
该研究表明，椎间盘造影和融合手术可能分别是诊断和治疗终板源性慢性背痛的非常有效的方法。
