Alamin Todd, Malek Farbod, Carragee Eugene, Kim Mi-Jung
Orthopaedics Surgery, Stanford University, Stanford, California.
Physiatry Department, Hanyang University, Seoul, South Korea.
SAS J. 2008 Jun 1;2(2):107-13. doi: 10.1016/SASJ-2007-0123-NT. eCollection 2008.
The diagnostic evaluation of patients with presumed discogenic low back pain is controversial; recent studies have brought the specificity of the traditional technique, provocative lumbar discography, into question. One of the explanations for the relative lack of predictability in treatment outcomes for patients with discogenic low back pain may be a corresponding lack of certainty in the diagnosis.
A new diagnostic technique is described for the evaluation of patients with presumptive discogenic low back pain; the cases of 3 patients in whom the technique was used are presented.
STUDY DESIGN/SETTING: Case report; university practice.
A technique is described in which an anaesthetic catheter is placed into putative symptomatic lumbar discs, the patient elicits his or her typical pain via a position or activity, and anaesthetic or placebo is delivered to the disc. The effect of the injected substance on the patient's pain is then noted.
In one patient, the new test was confirmatory of the results of the provocative discogram; in two patients, the test results were divergent.
These case studies and technical description are presented as a first step in examining this method of preoperative assessment. Further study of the technique will allow us to make more definitive recommendations with regards to its validity and utility.
Level 4 - Case Series.
对于疑似椎间盘源性下腰痛患者的诊断评估存在争议；近期研究对传统技术——激发性腰椎间盘造影术的特异性提出了质疑。椎间盘源性下腰痛患者治疗结果相对缺乏可预测性的一种解释可能是诊断方面相应缺乏确定性。
描述一种用于评估疑似椎间盘源性下腰痛患者的新诊断技术；并展示3例使用该技术的患者病例。
研究设计/地点：病例报告；大学医疗实践。
描述了一种技术，即将一根麻醉导管置入疑似有症状的腰椎间盘，患者通过某种姿势或活动引发其典型疼痛，然后向椎间盘注入麻醉剂或安慰剂。接着记录注入物质对患者疼痛的影响。
在1例患者中，新测试结果证实了激发性椎间盘造影的结果；在2例患者中，测试结果不一致。
这些病例研究和技术描述是检验这种术前评估方法的第一步。对该技术的进一步研究将使我们能够就其有效性和实用性提出更明确的建议。
4级——病例系列。
