诱发疼痛与椎间盘的病理变化──腰腿痛的CT椎间盘造影

The relationship between provocative pain and lumbar disc deterioration as seen by CT discography

作者对７３例腰腿痛患者进行了ＣＴＭ间盘造影检查，共１４６个间盘，其中突出５１个，退变９５个。根据造影中出现诱发疼痛与否，可分为无痛、非类似疼痛、类似疼痛和疼痛再现４类。椎间盘突出中６８． ９％有类似疼痛和疼痛再现。突出不合并或合并轻度退变时容易出现疼痛再现，合并严重退变则疼痛再现明显减少。无退变间盘常常是无痛的，退变间盘常有非类似疼痛。椎间盘造影诱发出的不同性质的疼痛有辅助诊断价值。疼痛的病理机制仍有待探讨。

The CT discographic findings from 146 discs in 73 low-back pain and sciatica patients were compared to the provocative pain during the injection of contrast into the disc. Pain reaction to the discogram at each level was recorded as following no pain, dissimilar pain, similar pain, or exact reproduction of the patient's clinical pain. The more precise analysis demonstrated a significant relationship between pain and deterioration of the discs. There were the similar pain and pain reproduction in 68. 9% of disruption. The degenerative discs were usually painful and non degenerative discs were generally not painful. The provocative pain is valuable in the diagnosis of low-back pain and sciatica patients with CT discography.