腰椎间盘磁共振正常的椎间盘源性腰痛

被引:2
作者
彭宝淦
庞晓东
李端明
匡正达
张新宇
杜明奎
高春华
机构
[1] 武警总医院脊柱外科研究所
关键词
椎间盘; 腰痛; 磁共振成像; 椎间盘造影术;
D O I
暂无
中图分类号
R686 [筋腱、韧带、滑囊疾病及损伤];
学科分类号
100220 [骨科学];
摘要
目的研究MRI显示椎间盘正常信号强度但椎间盘造影显示纤维环破裂和存在疼痛复制反应的椎间盘源性腰痛特殊病例,并对其产生的原因和意义进行探讨。方法 2003年8月至2008年11月,慢性下腰痛且行腰椎间盘造影术病人288例。其中腰椎MRIT2加权显示正常信号强度,但椎间盘造影术显示纤维环撕裂和腰痛复制的病人12例。男7例、女5例。年龄20~44岁,平均29.6岁。病程8个月~3年,平均1.8年。应用Dallas CT椎间盘造影分级方法评估纤维环撕裂程度。结果 12例慢性腰痛但MRI显示正常信号强度的病人中,共行腰椎间盘造影33个椎间盘。12个病人12个椎间盘显示疼痛复制和纤维环撕裂,其中显示2级撕裂者3个,3级撕裂者9个。结论对一些顽固性腰痛病人,保守治疗无效,提示是椎间盘源性的,但MRI检查正常需要行进一步治疗时,如行腰椎微创手术或腰椎融合术时,仍需考虑行腰椎间盘造影术,以确定疼痛的椎间盘。
引用
收藏
相关论文
共 7 条
[1]
Expression and Role of Connective Tissue Growth Factor in Painful Disc Fibrosis and Degeneration [J].
Peng, Baogan ;
Chen, Jindong ;
Kuang, Zhengda ;
Li, Duanming ;
Pang, Xiaodong ;
Zhang, Xinyu .
SPINE, 2009, 34 (05) :E178-E182
[2]
The pathogenesis and clinical significance of a high-intensity zone (HIZ) of lumbar intervertebral disc on MR imaging in the patient with discogenic low back pain [J].
Peng, BG ;
Hou, SX ;
Wu, WW ;
Zhang, CL ;
Yang, Y .
EUROPEAN SPINE JOURNAL, 2006, 15 (05) :583-587
[3]
Classification of Age-Related Changes in Lumbar Intervertebral Discs: 2002 Volvo Award in Basic Science.[J].Norbert Boos;Sabine Weissbach;Helmut Rohrbach;Christoph Weiler;Kevin F. Spratt;Andreas G. Nerlich.Spine.2002, 23
[4]
The value of lumbar spine magnetic resonance imaging in the demonstration of anular tears [J].
Saifuddin, A ;
Braithwaite, I ;
White, J ;
Taylor, BA ;
Renton, P .
SPINE, 1998, 23 (04) :453-457
[5]
Aging and Degeneration of the Human Intervertebral Disc.[J].Joseph A. Buckwalter.Spine.1995, 11
[6]
REPORTED PAIN DURING LUMBAR DISCOGRAPHY AS A FUNCTION OF ANULAR RUPTURES AND DISC DEGENERATION - A REANALYSIS OF 833 DISCOGRAMS [J].
MONETA, GB ;
VIDEMAN, T ;
KAIVANTO, K ;
APRILL, C ;
SPIVEY, M ;
VANHARANTA, H ;
SACHS, BL ;
GUYER, RD ;
HOCHSCHULER, SH ;
RASCHBAUM, RF ;
MOONEY, V .
SPINE, 1994, 19 (17) :1968-1974
[7]
NORMAL MAGNETIC-RESONANCE-IMAGING AND ABNORMAL DISCOGRAPHY IN LUMBAR DISC DISRUPTION [J].
BRIGHTBILL, TC ;
PILE, N ;
EICHELBERGER, RP ;
WHITMAN, M .
SPINE, 1994, 19 (09) :1075-1077