椎间盘造影术与椎间盘阻滞术在椎间盘源性腰痛中诊断结果的对比分析

目的比较分析椎间盘造影术与椎间盘阻滞术在椎间盘源性腰痛临床诊断中的检查结果。方法 2008年9～2011年9月收治78例慢性下腰痛患者,男32例,女46例,平均年龄38岁(29岁～46岁),临床表现及影像学检查考虑椎间盘源性腰痛。为进一步诊断进行椎间盘造影术,注射造影剂复制出平时典型腰痛者为阳性,造影诱发痛结果为单节段阳性者同时进行该节段椎间盘阻滞术,造影诱发痛结果为阴性者,选择临床高度怀疑的责任节段进行椎间盘阻滞术。椎间盘内阻滞后30 min,患者腰痛视觉模拟量表(visual analog scale,VAS)评分缓解60%以上者为阳性。记录并分析2种诊断方法的检查结果。结果椎间盘造影术:阳性60例,其中42例为单节段,18例为多节段;阴性18例。椎间盘阻滞术:42例单节段诱发痛阳性病例中30例椎间盘阻滞术阳性;18例诱发痛阴性病例中10例椎间盘阻滞术阳性。结论椎间盘阻滞术的检查结果与椎间盘造影术检查有差异,对椎间盘源性腰痛的诊断方法需要进一步的临床研究。

Provocative lumbar discography versus discoblock: a comparison of the results of 2 techniques in discogenic low back pain

Objective To compare the results between provocative discography and discoblock in a series of patients with chronic low back pain.Methods From September 2008 to September 2011,78 patients suffering from chronic low back pain including 32 men and 46 women with a mean age of 38 years（range 29-46 years） were involved in this study.All patients underwent discography,patients with positive at a single level underwent discoblock at the same level while patients with negative findings underwent discoblock at the most likely symptomatic segment.At 30 min after discoblock,the result was defined discoblock positive if the patients＇visual analogue scale（VAS） scores were less than 60% of their original VAS score before injection.Results Of all patients,60 cases show pain provocation by discography and 42 cases showed single level positive and others showed more than 1 level,18 patients had negative result.Of 42 single level positive patients,30 patients had positive discoblock result.Of 18 discography hegative patients,10 patients had positive discoblock result.Conclusion There is difference between the discordant results of the 2 tests and the diagnostic methods of discogenic low back need more studies.