Bartynski Walter S
Department of Radiology, Division of Neuroradiology, Presbyterian University Hospital, University of Pittsburgh Medical Center, Pittsburgh, PA 15213, USA.
Tech Vasc Interv Radiol. 2009 Mar;12(1):2-10. doi: 10.1053/j.tvir.2009.06.002.
Successful treatment of a patient's spine-related pain depends on accurate targeting of its location and cause. At a basic level, a focused history and physical examination is essential. Understanding of spine anatomy, in particular, spine innervation, is fundamental. Correlation with preprocedure imaging is important to confirm the suspected location(s) of the pain generator and is helpful in planning the approach for image-guided treatment. Understanding the variations in spine anatomy, subtle imaging features, or correlates of root irritation and factors that can affect the patient's presentation at the time of treatment are also critical to accurate targeting and effective treatment. This section reviews the fundamental elements that play a role in accurate diagnosis of the cause of a patient's spine-related pain. Routine application of these basic principles should aid in the approach to the spine-related pain patient and improve both accurate targeting of a patient's pain generator and the outcomes of image-guided treatment.
患者脊柱相关疼痛的成功治疗取决于对疼痛位置和病因的精准定位。在基础层面，详尽的病史采集和体格检查至关重要。尤其对脊柱解剖结构，特别是脊柱神经支配的了解是根本。与术前影像进行对照对于确认疼痛产生部位的可疑位置很重要，并且有助于规划影像引导治疗的方法。了解脊柱解剖结构的变异、细微的影像特征、神经根刺激的相关表现以及在治疗时可能影响患者症状的因素，对于精准定位和有效治疗也至关重要。本节回顾了在准确诊断患者脊柱相关疼痛病因中发挥作用的基本要素。常规应用这些基本原则应有助于对脊柱相关疼痛患者的诊治，提高对患者疼痛产生部位的精准定位以及影像引导治疗的效果。
