Kim Hyoung Ihl, Shin Dong Ah
Department of Neurosurgery, Presbyterian Medical Center, Jeonju, Korea.
J Korean Neurosurg Soc. 2009 Jul;46(1):16-22. doi: 10.3340/jkns.2009.46.1.16. Epub 2009 Jul 31.
This study was designed to investigate automated pressure-controlled discography (APCD) findings, to calculate the elastance of intervertebral discs, and to assess the relationship between the calculated elastance and disc degeneration.
APCD was performed in 19 patients. There were a total of 49 intervertebral discs treated. Following intradiscal puncture, a dye was constantly injected and the intradiscal pressure was continuously measured. The elastance of the intervertebral disc was defined as unit change in intradiscal pressure per fractional change in injected dye volume. Disc degeneration was graded using a modified Dallas discogram scale.
The mean elastance was 43.0 +/- 9.6 psi/mL in Grade 0, 39.5 +/- 8.3 psi/mL in Grade 1, 30.5 +/- 22.3 psi/mL in Grade 2, 30.5 +/- 22.3 psi/mL in Grade 3, 13.2 +/- 8.3 psi/mL in Grade 4 and 6.9 +/- 3.8 psi/mL in Grade 5. The elastance showed significant negative correlation with the degree of degeneration (R(2) = 0.529, p = 0.000).
APCD liberates the examiner from the data acquisition process during discography. This will likely improve the quality of data and the reliability of discography. Elastance could be used as an indicator of disc degeneration.
本研究旨在调查自动压力控制椎间盘造影（APCD）的结果，计算椎间盘的弹性，并评估计算出的弹性与椎间盘退变之间的关系。
对19例患者进行了APCD。共治疗了49个椎间盘。在椎间盘内穿刺后，持续注入染料并连续测量椎间盘内压力。椎间盘的弹性定义为注入染料体积的分数变化引起的椎间盘内压力单位变化。使用改良的达拉斯椎间盘造影量表对椎间盘退变进行分级。
0级的平均弹性为43.0±9.6 psi/mL，1级为39.5±8.3 psi/mL，2级为30.5±22.3 psi/mL，3级为30.5±22.3 psi/mL，4级为13.2±8.3 psi/mL，5级为6.9±3.8 psi/mL。弹性与退变程度呈显著负相关（R(2)=0.529，p = 0.000）。
APCD使检查者在椎间盘造影过程中从数据采集过程中解放出来。这可能会提高数据质量和椎间盘造影的可靠性。弹性可作为椎间盘退变的指标。
