Schwarzer A C, Wang S C, O'Driscoll D, Harrington T, Bogduk N, Laurent R
Faculty of Medicine, University of Newcastle, Royal North Shore Hospital, St Leonards, New South Wales, Australia.
Spine (Phila Pa 1976). 1995 Apr 15;20(8):907-12. doi: 10.1097/00007632-199504150-00005.
A prospective cross-sectional analytic study.
To assess in patients with chronic low back pain whether the presence or absence of pain originating from the lumbar zygapophysial joints correlates with changes seen on computed tomography.
Results of studies have been divided as to whether or not radiologic imaging is able to predict those patients with pain originating from the zygapophysial joints.
Sixty-three patients with low back pain lasting for longer than 3 months underwent computed tomography and blocks of the zygapophysial joints at L5-S1, L4-L5, and L3-L4. The zygapophysial joints of all images were scored by three independent, masked radiologists.
Interobserver agreement was poor with intraclass correlation coefficients of 0.34-0.66 using total joint scores for all three assessors. Using the results of a repeat assessment with two radiologists there was no statistically significant difference in joint scores between those with and those without pain originating from the zygapophysial joint.
Computed tomography has no place in the diagnosis of lumbar zygapophysial joint pain.
前瞻性横断面分析研究。
评估慢性下腰痛患者中，源自腰椎小关节的疼痛的有无是否与计算机断层扫描所见变化相关。
关于放射学成像能否预测源自小关节的疼痛患者，研究结果存在分歧。
63例下腰痛持续超过3个月的患者接受了L5-S1、L4-L5和L3-L4节段小关节的计算机断层扫描及阻滞。所有图像的小关节由三名独立的、不知情的放射科医生评分。
三位评估者使用总关节评分时，组内相关系数为0.34 - 0.66，观察者间一致性较差。根据两名放射科医生的重复评估结果，源自小关节疼痛的患者与无此疼痛的患者之间，关节评分无统计学显著差异。
计算机断层扫描在腰椎小关节疼痛的诊断中并无用武之地。
