Zeidman S M, Thompson K, Ducker T B
Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
Neurosurgery. 1995 Sep;37(3):414-7. doi: 10.1227/00006123-199509000-00007.
Despite extensive experience with diagnostic cervical disc injection, the role of this procedure in the evaluation of patients with degenerative disc disease and severe neck pain remains controversial. Beyond the debate regarding its efficacy in identifying the site of cervical symptomatology and directing appropriate intervention are the potential morbidity and mortality associated with this diagnostic procedure. Discitis, subdural empyema, spinal cord injury, vascular injury, and prevertebral abscess have all been reported as complications of diagnostic cervical disc injection. Any meaningful assessment of the role of cervical discography in the evaluation of degenerative disc disease must include a determination of the risks inherent in the procedure. We retrospectively analyzed 4400 cervical disc injections in 1357 patients performed by an experienced radiologist between 1988 and 1993 to define the morbidity and mortality associated with discography. In addition, we reviewed the extant medical literature on the complications of this controversial procedure. This study demonstrates significant complications from diagnostic discography procedures occurring in less than 0.6% of the patients and 0.16% of the cervical disc injections.
尽管在诊断性颈椎间盘注射方面有着丰富经验，但该操作在评估椎间盘退变疾病和严重颈部疼痛患者时的作用仍存在争议。除了关于其在确定颈椎症状部位及指导适当干预方面疗效的争论外，该诊断性操作还存在潜在的发病率和死亡率。椎间盘炎、硬膜下积脓、脊髓损伤、血管损伤和椎前脓肿均已被报道为诊断性颈椎间盘注射的并发症。对颈椎间盘造影术在椎间盘退变疾病评估中作用的任何有意义的评估都必须包括对该操作固有风险的判定。我们回顾性分析了一位经验丰富的放射科医生在1988年至1993年间对1357例患者进行的4400次颈椎间盘注射，以确定与椎间盘造影相关的发病率和死亡率。此外，我们还查阅了关于这一有争议操作并发症的现有医学文献。本研究表明，诊断性椎间盘造影术的严重并发症发生率在不到0.6%的患者和0.16%的颈椎间盘注射中出现。
