Moneta G B, Videman T, Kaivanto K, Aprill C, Spivey M, Vanharanta H, Sachs B L, Guyer R D, Hochschuler S H, Raschbaum R F
Institute of Occupational Health, Helsinki, Finland.
Spine (Phila Pa 1976). 1994 Sep 1;19(17):1968-74. doi: 10.1097/00007632-199409000-00018.
This re-analysis was based on 833 computed tomography/discograms collected from 306 candidates for back surgery.
The goal was to test the hypothesis that outer anular ruptures are the main determinant of the pain of discography.
Previous analyses indicated univariate associations of pain with disc degeneration and anular ruptures.
If present, pain was classified as "exact", "similar", or "dissimilar" reproduction of the previously experienced pain. For each disc, ruptures and degeneration were separately evaluated by a four-point scale. Multiple logistic regression with random effects was used in the analysis.
Outer anular ruptures were the only predictor of the responses "similar" and "exact". General disc degeneration was the only predictor of the response "dissimilar". There was no effect modification due to gender, age, and spinal level.
During discography, the outer anulus appears to be the origin of pain reproduction.
本重新分析基于从306名腰椎手术候选者收集的833份计算机断层扫描/椎间盘造影图像。
目的是检验外侧纤维环破裂是椎间盘造影疼痛的主要决定因素这一假设。
先前的分析表明疼痛与椎间盘退变和纤维环破裂存在单变量关联。
若存在疼痛，则将其分类为先前经历疼痛的“确切”、“相似”或“不相似”再现。对每个椎间盘，通过四点量表分别评估破裂和退变情况。分析中使用了具有随机效应的多元逻辑回归。
外侧纤维环破裂是“相似”和“确切”反应的唯一预测因素。一般的椎间盘退变是“不相似”反应的唯一预测因素。不存在因性别、年龄和脊柱节段导致的效应修正。
在椎间盘造影期间，外侧纤维环似乎是疼痛再现的起源。
