Méndez-Gutiérrez A, Marín Navas F, Acevedo-González J C
Pontificia Universidad Javeriana, Hospital Universitario San Ignacio, Bogotá, Colombia.
Semillero de Neurocirugía y Neurología, Pontificia Universidad Javeriana, Bogotá, Colombia.
Rev Esp Cir Ortop Traumatol. 2024 May-Jun;68(3):T209-T222. doi: 10.1016/j.recot.2024.03.008. Epub 2024 Mar 18.
There are different techniques and interpretations of discography findings to determine it positive for the diagnosis of discogenic pain. This study aims to evaluate the frequency of use of discography findings for the diagnosis of low back pain of discogenic origin.
A systematic review of the literature of the last 17 years was performed in MEDLINE and BIREME. A total of 625 articles were identified, 555 were excluded for duplicates, title and abstract. We obtained 70 full texts of which 36 were included in the analysis after excluding 34 for not meeting the inclusion criteria.
Among the criteria in discography to determine it as positive, 8 studies used only the pain response to the procedure, 28 studies used more than one criterion during discography to consider it as positive, the evaluation of at least one adjacent intervertebral disc with a negative result was necessary in 26 studies to consider a discography as positive. Five studies formally expressed the use of the technique described by SIS/IASP to determine a discography as positive.
Pain in response to contrast medium injection, assessed with the visual analogue pain scale ≥6, was the most used criterion in the studies included in this review. Although there are already criteria to determine a discography as positive, the use of different techniques and interpretations of discography findings to determine a positive discography for low back pain of discogenic origin persists.
对于椎间盘造影结果的判定,存在不同的技术和解读方法,以确定其对椎间盘源性疼痛诊断呈阳性。本研究旨在评估利用椎间盘造影结果诊断椎间盘源性下腰痛的使用频率。
在MEDLINE和BIREME数据库中对过去17年的文献进行系统综述。共识别出625篇文章,因重复、标题和摘要原因排除555篇。我们获得了70篇全文,排除34篇不符合纳入标准的文章后,36篇纳入分析。
在椎间盘造影判定为阳性的标准中,8项研究仅使用对该操作的疼痛反应,28项研究在椎间盘造影期间使用多个标准将其判定为阳性,26项研究中需要评估至少一个相邻椎间盘结果为阴性才能将椎间盘造影判定为阳性。5项研究正式表示使用SIS/IASP描述的技术将椎间盘造影判定为阳性。
本综述纳入的研究中,使用视觉模拟疼痛量表评估,对比剂注射后疼痛≥6是最常用的标准。尽管已有判定椎间盘造影为阳性的标准,但对于椎间盘源性下腰痛,使用不同技术和解读椎间盘造影结果来判定阳性椎间盘造影的情况仍然存在。