THE TREATMENT OF LUMBAR SPINAL PAIN SYNDROMES DIAGNOSED BY DISCOGRAPHY - LUMBAR ARTHRODESIS

被引:63
作者
WETZEL, FT
LAROCCA, SH
LOWERY, GL
APRILL, CN
机构
[1] The Division of Orthopaedic Surgery, The Pennsylvania State University College of Medicine, The Milton S. Hershey Medical Center, Hershey, PA
关键词
Discogenic pain syndromes; Lumbar discography; Spinal arthrodesis;
D O I
10.1097/00007632-199404000-00012
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Study Design. This retrospective review of patients whose discogenic pain syndromes were treated by lumbar arthrodesis was designed to examine the clinical efficacy of this diagnostic modality and analyze possible confounding variables. Objectives. Clinical outcome was examined with respect to status of the arthrodesis, discographic diagnosis, and demographic variables. Summary of Background Data. Discography continues to be a controversial diagnostic technique for spinal pain syndromes. The morphologic information provided by discography is well known. However, disagreement exists concerning the clinical utility of the pain provoked by this modality. Methods. Forty-eight patients were included in this study. In all patients, the chief complaint was low back pain. In all patients, the definitive diagnostic technique was lumbar discography followed by computerized tomographic scanning. All patients underwent lumbar arthrodesis. Data were collected in four categories: 1) demographic characteristics, 2) physical findings, 3) results of diagnostic studies, and 4) characteristics of surgical procedures. Data from these categories were studied with respect to clinical rating and status of the arthrodesis. Results. Overall, 46% were judged to have a satisfactory clinical outcome at final follow-up. Forty-eight percent were judged to have a solid arthrodesis. Conclusions. Based on the results of this study, it appears that discogenic pain syndromes can be treated by arthrodesis.
引用
收藏
页码:792 / 800
页数:9
相关论文
共 64 条
[1]  
Position Statement on Discography, Spine, 13, (1988)
[2]  
Adams M.A., Dolan P., Hutton W.C., The stages of disc degeneration as revealed by discograms, J Bone Joint Surg [Br], 68, pp. 36-41, (1986)
[3]  
Aejemelaeus R., Hiltunen H., Harkonen M., Et al., Myelographic versus clinical diagnostics in lumbar disc disease, Arch Orthop Trauma Surg, 103, pp. 18-25, (1984)
[4]  
Bell G.R., Rothman R.H., Booth R.E., Et al., A study of computer-assisted tomography: A comparison of metrizamide myelography and computed tomography in the diagnosis of herniated lumbar discs and spinal stenosis, Spine, 9, pp. 552-556, (1984)
[5]  
Blumenthal S.L., Baker J., Dossett A., Selby D.K., The role of anterior lumbar fusion for internal disc disruption, Spine, 13, pp. 566-569, (1988)
[6]  
Boden S.D., Davis D.O., Dina T.S., Patronas N.J., Wiesel S.W., The incidence of abnormal lumbar spine, MRI scans in asymptomatic patients: A prospective and blinded investigation, Orthopaedic Transactions, 14, (1990)
[7]  
Bosacco S.J., Burman A.T., Garbarino J.L., Teplick J.G., Peyster R., A comparison of CT scanning and myelography in the diagnosis of lumbar disc herniation, Clin Orthop, 190, pp. 124-128, (1984)
[8]  
Brown C.W., Orme T.J., Richardson H.D., The rate of pseudoarthrosis (Surgical nonunion) in patients who are smokers and patients who are nonsmokers A comparison study, Spine, 11, pp. 942-943, (1986)
[9]  
Colhoun E., McCall I.W., Williams L., Cassar Pullicino V.N., Provocation discography as a guide to planning operations on the spine, J Bone Joint Surg [Br], 70, pp. 267-271, (1988)
[10]  
Crock H.V., Internal disc disruption: A challenge to disc prolapse fifty years on. The Presidential Address: International Society for the Study of Lumbar Spine, Spine, 11, pp. 650-653, (1986)