Ito M, Incorvaia K M, Yu S F, Fredrickson B E, Yuan H A, Rosenbaum A E
Department of Orthopaedics, Hokkaido University School of Medicine, Sapporo, Japan.
Spine (Phila Pa 1976). 1998 Jun 1;23(11):1252-8; discussion 1259-60. doi: 10.1097/00007632-199806010-00016.
The correlation between discogenic lumbar pain and disc morphology was investigated by using magnetic resonance imaging and discography.
To assess the various pathologic parameters seen on magnetic resonance imaging in patients with discogenic lumbar pain and to correlate them with observations on discography.
Although numerous previous studies on the subject have been performed, the correlations between various pathologic findings on magnetic resonance imaging and pain reproduction by provoked discography have not been explained fully.
One hundred and one lumbar discs in 39 patients were studied with magnetic resonance imaging and pain provocation discography. When pain reproduction under discography was concordant, various pathologic parameters on magnetic resonance imaging were analyzed by three statistical parameters to determine the associated magnetic resonance imaging findings.
Radial tears commonly are demonstrated on magnetic resonance imaging in discs with concordant pain on discography. The presence of these tears is not a reliable predictor of a painful disc on discography. Although a high-intensity zone on T2-weighted images is a relatively reliable predictor of pain, the statistical values were lower than those in previous studies. Massive degeneration and severe disc height loss were rare in this population. These findings were good predictors of pain on disc injection.
Although the lumbar intervertebral discs with posterior combined anular tears are likely to produce pain, the validity of these signs for predicting discogenic lumbar pain is limited.
采用磁共振成像和椎间盘造影术研究椎间盘源性腰痛与椎间盘形态之间的相关性。
评估椎间盘源性腰痛患者磁共振成像上可见的各种病理参数，并将其与椎间盘造影的观察结果相关联。
尽管此前已针对该主题开展了大量研究，但磁共振成像上各种病理发现与激发性椎间盘造影术引起的疼痛再现之间的相关性尚未得到充分解释。
对39例患者的101个腰椎间盘进行磁共振成像和激发性椎间盘造影术研究。当椎间盘造影术中的疼痛再现一致时，通过三个统计参数分析磁共振成像上的各种病理参数，以确定相关的磁共振成像表现。
在椎间盘造影术中疼痛一致的椎间盘，其放射状撕裂在磁共振成像上通常可见。这些撕裂的存在并非椎间盘造影术中疼痛椎间盘的可靠预测指标。尽管T2加权图像上的高信号区是疼痛的相对可靠预测指标，但统计值低于先前研究中的值。该人群中大量退变和严重椎间盘高度丢失的情况罕见。这些发现是椎间盘注射时疼痛的良好预测指标。
尽管伴有后方联合纤维环撕裂的腰椎间盘可能产生疼痛，但这些体征预测椎间盘源性腰痛的有效性有限。
