Department of Physical Medicine and Rehabilitation, Virginia Commonwealth University/Medical College of Virginia Hospitals, Richmond, Virginia, USA.
Pain Med. 2011 Feb;12(2):224-33. doi: 10.1111/j.1526-4637.2010.01045.x. Epub 2011 Jan 25.
The objective of this study was to estimate the prevalence, mean age, and association of prevalence and age of lumbar internal disc disruption (IDD), facet joint pain (FJP), sacroiliac joint pain (SIJP), spinal and pelvic insufficiency fractures, interspinous ligament injury/Baastrup's Disease, and soft tissue irritation by fusion hardware.
The study's design was a retrospective chart review.
The study was set in an academic spine center.
A total of 378 cases from 358 patients were reviewed of which 170 cases from 156 patients who underwent diagnostic procedures were included.
Discography, dual diagnostic facet joint blocks, intra-articular sacroiliac joint injections, anesthetic injections of painful interspinous ligaments/opposing spinous processes/posterior fusion hardware, or percutaneous augmentation were performed.
Prevalence and age were analyzed for each diagnosis group.
Patients with recalcitrant low back pain underwent diagnostic procedures based on their clinical presentation until the pain source was identified.
The prevalence of internal disc disruption, facet joint pain and sacroiliac joint pain was 42%, 31%, and 18%, respectively. Patients with internal disc disruption were significantly younger than those with facet joint pain or sacroiliac joint pain. Increased age was associated with a decreased probability of internal disc disruption and increased probabilities of facet joint pain and sacroiliac joint pain as the source of low back pain until approximately age 70.
Our data confirm the intervertebral disc as the most common etiology of chronic low back pain in adults. Based on our sample, the younger the patient, the more likely low back pain is discogenic in origin. Facetogenic or sacroiliac joint pain is more likely in older patients.
本研究旨在估计腰椎内部椎间盘破裂（IDD）、小关节疼痛（FJP）、骶髂关节疼痛（SIJP）、脊柱和骨盆不稳定性骨折、棘间韧带损伤/巴斯楚普病以及融合硬件相关软组织刺激的患病率、平均年龄以及与患病率和年龄的相关性。
本研究设计为回顾性图表审查。
本研究在一家学术脊柱中心进行。
共对 358 名患者中的 378 例进行了回顾，其中 170 例来自 156 名接受诊断程序的患者被纳入。
进行了椎间盘造影术、双诊断小关节阻滞、关节内骶髂关节注射、疼痛性棘间韧带/对向棘突/后融合硬件麻醉注射或经皮增强术。
对每个诊断组的患病率和年龄进行分析。
根据临床表现对患有顽固性腰痛的患者进行诊断程序，直到确定疼痛源。
内部椎间盘破裂、小关节疼痛和骶髂关节疼痛的患病率分别为 42%、31%和 18%。患有内部椎间盘破裂的患者明显比患有小关节疼痛或骶髂关节疼痛的患者年轻。年龄的增加与内部椎间盘破裂的可能性降低以及小关节疼痛和骶髂关节疼痛作为腰痛来源的可能性增加有关，直到大约 70 岁。
我们的数据证实椎间盘是成年人慢性腰痛的最常见病因。根据我们的样本，患者越年轻，腰痛越有可能是椎间盘源性的。在老年患者中，小关节或骶髂关节疼痛更常见。
