Pelz D M, Haddad R G
Department of Diagnostic Radiology, University Hospital, London, Ont.
CMAJ. 1989 Feb 1;140(3):289-95.
Low back pain is one of the commonest disorders, yet is the most confusing. The cost in work-time lost and in the search for and treatment of its many causes amounts to billions of dollars annually. The traditional techniques for anatomic visualization have been plain-film radiography and myelography, but they have limitations. The development of computed tomography and magnetic resonance imaging have substantially improved anatomic imaging. However, invasive procedures, such as discography, percutaneous nerve-root blocking and percutaneous facet injection, may be helpful in patients with disabling pain in whom noninvasive methods give negative findings, show abnormalities that do not correlate with the symptoms or identify multiple sites of disease. The invasive procedures are believed by some to be associated with too many complications. We have attempted to clarify the strengths and weaknesses of the currently available methods of investigating low back pain and the indications for their use.
腰痛是最常见的病症之一，但也是最令人困惑的。每年因误工以及寻找和治疗其多种病因所花费的成本高达数十亿美元。传统的解剖可视化技术是普通X线摄影和脊髓造影，但它们存在局限性。计算机断层扫描和磁共振成像的发展极大地改善了解剖成像。然而，对于无创方法检查结果为阴性、显示与症状不相关的异常或确定多个疾病部位的致残性疼痛患者，椎间盘造影、经皮神经根阻滞和经皮小关节注射等侵入性操作可能会有所帮助。一些人认为侵入性操作会带来太多并发症。我们试图阐明目前可用的腰痛检查方法的优缺点及其使用指征。
