CHA University College of Medicine, Seoul, Korea.
Spine (Phila Pa 1976). 2009 Oct 15;34(22):E790-3. doi: 10.1097/BRS.0b013e3181ba2a8d.
In vitro laboratory study.
The aim of this study was to evaluate the effects of injection speed, contrast viscosity, and needle profile on manometric pressures during discography.
As the degree of the response in a provocation test depends on the intensity of the stimulus, the precise measurement of intradiscal pressure during discography is crucial. Although manometric pressure measurement is safe and easy, manometric pressures may be affected by potential confounding factors, including injection speed, contrast viscosity, and needle profile.
Pressure-controlled discography was performed using an automated pressure-controlled discography system in a total of 60 intervertebral discs in 2 porcine cadavers. Dynamic pressures were measured while changing the following parameters: injection speed (0.01 mL/s vs. 0.08 mL/s), media viscosity (Visipaque vs. normal saline), needle diameter (18G vs. 22G), and needle length (7 inch vs. 3.5 inch). The unit change in manometric pressure per fractional change in injected volume (dP/dV) was used for statistical analysis.
The mean dP/dV increased from 137.9 +/- 11.3 at 0.08 mL/s to 160.3 +/- 12.5 at 0.01 mL/s. Visipaque injection resulted in a higher mean dP/dV than the normal saline injection (160.3 +/- 12.5 vs. 97.8 +/- 34.1). A 7.5 inch needle had a higher mean dP/dV than a 3.5 inch needle (137.9 +/- 11.3 vs. 92.5 +/- 48.6). The mean dP/dV of the 22G needle was higher than the 18G needle (137.9 +/- 11.3 vs. 84.7 +/- 28.3).
High injection speed, high viscosity, small diameter, and a long needle increase the dynamic pressure. To minimize the differences among examiners, we recommend standardization of injection speed, the viscosity of the injected material, and the diameter and length of the needle.
体外实验室研究。
本研究旨在评估注射速度、对比粘度和针型对椎间盘造影时测压的影响。
由于激发试验的反应程度取决于刺激的强度，因此椎间盘造影时准确测量椎间盘内压力至关重要。尽管压力测量安全且简单，但压力测量可能会受到潜在混杂因素的影响，包括注射速度、对比粘度和针型。
在 2 头猪尸体的总共 60 个椎间盘中使用自动压力控制椎间盘造影系统进行压力控制椎间盘造影。在改变以下参数时测量动态压力：注射速度（0.01mL/s 与 0.08mL/s）、介质粘度（Visipaque 与生理盐水）、针直径（18G 与 22G）和针长度（7 英寸与 3.5 英寸）。使用单位变化的压力除以注入体积的分数变化（dP/dV）进行统计学分析。
注射速度从 0.08mL/s 时的平均 dP/dV 137.9±11.3 增加到 0.01mL/s 时的 160.3±12.5。Visipaque 注射的平均 dP/dV 高于生理盐水注射（160.3±12.5 与 97.8±34.1）。7.5 英寸的针的平均 dP/dV 高于 3.5 英寸的针（137.9±11.3 与 92.5±48.6）。22G 针的平均 dP/dV 高于 18G 针（137.9±11.3 与 84.7±28.3）。
高注射速度、高粘度、小直径和长针会增加动态压力。为了最大限度地减少检查者之间的差异，我们建议标准化注射速度、注入材料的粘度以及针的直径和长度。
