THE RELATIVE CONTRIBUTIONS OF THE DISC AND ZYGAPOPHYSEAL JOINT IN CHRONIC LOW-BACK-PAIN

被引：290

作者：

SCHWARZER, AC

APRILL, CN

DERBY, R

FORTIN, J

KINE, G

BOGDUK, N

机构：

[1] Magnolia Diagnostics Inc., New Orleans, LA

[2] Spinecare, Daly City, CA

[3] Diagnostic Conservative Management, New Orleans, LA

[4] The University of Newcastle, University Drive, Callaghan

来源：

SPINE | 1994年 / 19卷 / 07期

关键词：

Back pain; Discography; Intervertebral disc; Zygapophyseal joint;

D O I：

10.1097/00007632-199404000-00013

中图分类号：

R74 [神经病学与精神病学];

学科分类号：

摘要：

Study Design. A prospective cross-sectional analytic approach was taken. Objectives. This study sought to determine the relative contribution of the disc and the zygapophyseal joint as a pain source in patients with chronic low back pain. Summary of Background Data. Previous studies have employed either zygapophyseal joint blocks or discography, but in no studies have both procedures been performed. Methods. Ninety-two consecutive patients with chronic low back pain were studied using both discography and blocks of the zygapophyseal joints. Results. Thirty-six patients (39%) had at least one positive discogram as defined by exact pain reproduction, an abnormal image, and a negative control. Eight patients responded to both a screening zygapophyseal joint block using lignocaine and a confirmatory block using bupivacaine. Only three patients had both a positive discogram and a symptomatic zygapophyseal joint. Conclusions. In patients with chronic low back pain, the combination of discogenic pain and zygapophyseal joint pain is uncommon.

引用

页码：801 / 806

页数：6

共 23 条

[1]

Aprill C., Bogduk N., High-intensity zone: A diagnostic sign of painful lumbar disc on magnetic resonance imaging, Br J Radiol, 65, pp. 361-369, (1992)

[2]

Aprill C.N., Diagnostic disc injection, The Adult Spine: Principles and Practice, pp. 403-442, (1991)

[3]

Barnsley L., Lord S., Bogduk N., Comparative local anaesthetic blocks in the diagnosis of cervical zygapophysial joint pain, Pain, 55, pp. 99-106, (1993)

[4]

Boas R.A., Nerve blocks in the diagnosis of low back pain, Neurosurgery Clinics of North America, 2, pp. 807-816, (1991)

[5]

Boas R.A., Cousins M.J., Diagnostic neural blockade, Neural Blockade in Clinical Anaesthesia and Management of Pain, pp. 885-898, (1988)

[6]

Bogduk N., The Sources of Low Back Pain, pp. 61-88, (1992)

[7]

Bogduk N., Aprill C., Derby R., Lumbar zygapophysial joint pain, Diagnostic Blocks and Therapy

[8]

Bonica J.J., Local Anaesthesia and Regional Blocks, pp. 724-743, (1989)

[9]

Bonica J.J., Buckley F.P., Regional analgesia with local anesthetics, The Management of Pain, pp. 1883-1966, (1990)

[10]

Butler D., Trafimow J.H., Ersson G.B., McNeill T.W., Huckman M.S., Discs degenerate before facets, Spine, 15, pp. 111-113, (1990)

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