Ellis Deion L, Ehsanian Reza, Shin Peter C, Rivers William E
Physical Medicine & Rehabilitation, University of New Mexico School of Medicine, Albuquerque, USA.
Neurosurgery, University of New Mexico School of Medicine, Albuquerque, USA.
Cureus. 2021 Dec 2;13(12):e20111. doi: 10.7759/cureus.20111. eCollection 2021 Dec.
Low back pain (LBP) is a common affliction with numerous causes. Some individuals experience LBP attributed to disc pathology. Disc pathology has been implicated in a plurality of cases of LBP, and some cases are associated with annular fissures (AFs). AFs are weaknesses in the structure that contains the nucleus pulposus and is the site of possible disc herniations. On magnetic resonance imaging (MRI), some AFs manifest as the high-intensity zone (HIZ), otherwise known as an annular enhancement region. In this report, we present three patients with LBP, mild radiculitis, and HIZ who later developed herniated nucleus pulposus (HNP) with extrusion through the HIZ. These cases suggest that HIZ indicates a propensity for the future development of disc extrusion through the weakened tissue at the AF visualized as HIZ on MRI. With a better understanding of the association between AFs and disc herniations with HIZ, clinicians may be able to predict and prevent the pain and disability associated with disc extrusion.
腰痛（LBP）是一种病因众多的常见疾病。一些人经历的腰痛归因于椎间盘病变。椎间盘病变与众多腰痛病例有关，有些病例与环状裂隙（AFs）相关。AFs是包含髓核的结构中的薄弱点，也是可能发生椎间盘突出的部位。在磁共振成像（MRI）上，一些AFs表现为高强度区（HIZ），也称为环状强化区域。在本报告中，我们介绍了三名患有腰痛、轻度神经根炎和HIZ的患者，他们后来发展为髓核突出（HNP）并通过HIZ挤出。这些病例表明，HIZ表明未来椎间盘通过在MRI上显示为HIZ的AF处的薄弱组织发生挤出的倾向。通过更好地理解AFs与伴有HIZ的椎间盘突出之间的关联，临床医生或许能够预测并预防与椎间盘挤出相关的疼痛和残疾。
