Ricketson R, Simmons J W, Hauser B O
Edmond Spine Center, Edmond, Oklahoma.
Spine (Phila Pa 1976). 1996 Dec 1;21(23):2758-62. doi: 10.1097/00007632-199612010-00010.
The study compared the presence of the high-intensity zone on magnetic resonance imaging with the results of awake discography.
To see if there was a correlation between the results of awake discography and the presence of a high-intensity zone on magnetic resonance imaging.
The evaluation of discogenic pain has proved to be somewhat elusive. Recent studies have indicated the high-intensity zone as being highly sensitive in the diagnosis of the painful discogenic segment. The present study was designed to investigate whether the presence of a high-intensity zone is associated with a concordant pain response on awake discography.
Magnetic resonance images were obtained in 29 patients with low back pain with and without radiculopathy. Consecutive patients were considered for surgical intervention after falling to respond to conservative treatment. The presence of a high-intensity zone was specifically looked for within the posterior anulus. Each patient subsequently underwent awake discography with computed tomography. Computed tomography was classified according to the Dallas Discogram Scale and the presence of a concordant pain response. Chi-square analysis was used to calculate the presence of a high-intensity zone versus disc disruption and the correlation of high-intensity zone and concordant pain response.
There was no statistically significant correlation between the presence of a high-intensity zone and a concordant pain response at any level. The high-intensity zone was, however, never seen in a morphologically normal disc.
Although the high-intensity zone is present within the posterior anulus of some abnormal discs, it is not necessarily associated with a concordant pain response.
本研究比较了磁共振成像上高强度区的存在情况与清醒状态下椎间盘造影的结果。
观察清醒状态下椎间盘造影的结果与磁共振成像上高强度区的存在之间是否存在相关性。
椎间盘源性疼痛的评估已被证明有些难以捉摸。最近的研究表明，高强度区在诊断疼痛性椎间盘源性节段方面具有高度敏感性。本研究旨在调查高强度区的存在是否与清醒状态下椎间盘造影时的一致性疼痛反应相关。
对29例有或无神经根病的腰痛患者进行了磁共振成像检查。连续的患者在对保守治疗无反应后被考虑进行手术干预。特别在纤维环后部寻找高强度区的存在。随后，每位患者均接受了计算机断层扫描引导下的清醒椎间盘造影。计算机断层扫描根据达拉斯椎间盘造影量表进行分类，并判断是否存在一致性疼痛反应。采用卡方分析来计算高强度区的存在与椎间盘破裂之间的关系，以及高强度区与一致性疼痛反应之间的相关性。
在任何节段，高强度区的存在与一致性疼痛反应之间均无统计学意义上的相关性。然而，在形态正常的椎间盘中从未见过高强度区。
虽然在一些异常椎间盘的纤维环后部存在高强度区，但它不一定与一致性疼痛反应相关。
