Department of Orthopaedics, Changzheng Hospital, Second Military Medical University, 415 Fengyang Road, Shanghai, 200003, China.
Department of Orthopaedic Surgery, The 175th Hospital of PLA, Orthopaedics Center of PLA, Affiliated Southeast Hospital of Xiamen University, Zhangzhou, 363000, Fujian Province, China.
Eur Spine J. 2019 May;28(5):1014-1022. doi: 10.1007/s00586-019-05927-0. Epub 2019 Mar 12.
Discography can increase disc degeneration, but the influence of different discography variables on the degeneration of discs has not been reported. The aim of this study was to investigate the effects of discography variables of needle diameter, type of contrast agent and volume of contrast agent on disc degeneration.
Three separate experiments examined needle diameter, and type and volume of contrast agent. Coccygeal discs (Co7-10) adult male rats were used. X-rays were used to detect the disc height degeneration index at 1, 2 and 4 weeks after the procedure. MRI was used to study the changes in the disc structure and the signal intensity of IVD 2 and 4 weeks after the procedure. Disc water content and histology were measured at 4 weeks after the procedure.
A 21-g needle significantly increased disc degeneration when compared with the 30-g needle as detected by X-ray, MRI, disc water content and histology (P < 0.05). Two microlitres of iodine significantly decreased the disc MRI signal and water content at 4 weeks compared with the same volume of normal saline (P < 0.05). Three microlitres of iodine significantly increased disc degeneration when compared with 2 µl iodine, as detected by X-ray, MRI, disc water content and histology at 4 weeks (P < 0.05).
To reduce disc degeneration after discography, it may be best to choose a smaller needle size, minimize the use of contrast agent and use non-ionic contrast agents with osmotic pressure similar to the intervertebral disc. These slides can be retrieved under Electronic Supplementary Material.
椎间盘造影术可加重椎间盘退变，但不同椎间盘造影术变量对椎间盘退变的影响尚未见报道。本研究旨在探讨针直径、造影剂类型和造影剂体积等椎间盘造影术变量对椎间盘退变的影响。
本研究共进行了 3 项独立实验，分别考察了针直径、造影剂类型和造影剂体积。选用成年雄性大鼠尾骨 Co7-10 椎间盘。于术后 1、2、4 周行 X 线检查，检测椎间盘高度退变指数；于术后 2、4 周行 MRI 检查，观察椎间盘结构及椎间盘内信号强度的变化；于术后 4 周测量椎间盘含水量并进行组织学检查。
与 30-g 针相比，21-g 针行椎间盘造影后 X 线、MRI、椎间盘含水量和组织学检查均显著加重了椎间盘退变（P<0.05）。与等量生理盐水相比，2 µl 碘造影剂在术后 4 周时显著降低了 MRI 信号和椎间盘含水量（P<0.05）。与 2 µl 碘相比，3 µl 碘在术后 4 周时 X 线、MRI、椎间盘含水量和组织学检查均显著加重了椎间盘退变（P<0.05）。
为减少椎间盘造影术后椎间盘退变，最好选择较小的针径，尽量减少造影剂的使用，并使用渗透压与椎间盘相似的非离子型造影剂。这些幻灯片可在电子补充材料中查看。
