Endplate degeneration observed on magnetic resonance imaging of the lumbar spine - Correlation with pain provocation and disc changes observed on computed tomography diskography
Endplate degeneration observed on magnetic resonance imaging of the lumbar spine - Correlation with pain provocation and disc changes observed on computed tomography diskography
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DOI：
10.1097/00007632-200210150-00017
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发表时间：
2002-10-15
期刊：
影响因子：
3
通讯作者：
Vanharanta, H
中科院分区：
文献类型：
--
作者：
Kokkonen, SM;Kurunlahti, M;Vanharanta, H
研究设计.对36例下腰痛患者的103个腰椎间盘（L3/4-L5/S1）进行了计算机断层扫描（CT）椎间盘造影和磁共振成像（MRI）检查。确定腰椎终板退变是否与椎间盘退变或椎间盘破裂的程度相关，并确定椎间盘造影时疼痛激发与腰椎终板退变之间是否存在相关性。已经有许多人试图解释椎间盘造影术中疼痛激发的发病机制，但终板退变作为疼痛来源的可能性尚未得到广泛评估。103个腰椎间盘。(36对36例腰椎间盘（L3/4、L4/5、L5/S1椎间盘各31个）进行MRI检查，根据终板退变程度将椎间盘分为4类。根据椎间盘造影的疼痛激发，将椎间盘分为三类：无疼痛、无症状/不典型疼痛和熟悉/典型疼痛。根据椎间盘退变和破裂程度，按达拉斯椎间盘造影描述将椎间盘分为4类：退变和破裂均为0-3级。终板退变和椎间盘退变之间呈正相关，椎间盘破裂和疼痛激发之间呈正相关;但终板退变和椎间盘破裂之间无相关性，椎间盘造影显示终板退变和疼痛激发之间无相关性：结论。这项研究表明终板退变和椎间盘退变之间的关联性比终板退变和椎间盘破裂之间的关联性更强。结果表明，椎间盘造影时注射造影剂主要反映椎间盘源性疼痛，而可能与终板损伤相关的疼痛不能通过CT椎间盘造影来描述。
Study Design. One hundred and three lumbar intervertebtal discs (L3/4-L5/S1) of 36 patients with low back pain were examined with computed tomography (CT) diskography and magnetic resonance imaging (MRI).Objectives.: To determine whether lumbar endplate degeneration correlates with-the degree of disc degeneration or disc rupture and to determine if there is an association between pain provocation during diskography and lumbar endplate degeneration.Summary of Background Data. There have been numerous attempts to explain the pathogenesis of pain provocation during, diskography, but the possibility of endplate degeneration-as a;source of pain has not been widely assessed.Methods. One hundred and three lumbar intervertebral discs. (36 L3/4, 36 L4/5; and 31 L5/S1 intervertebral discs) of 36 patients were examined: On the basis of MRI, the intervertebral discs were divided into four categories based on the degree of endplate degeneration. Based on pain provocation on diskography, the intervertebral discs were divided into three, categories: no pain, indifferent/untypical pain, and familiar/typical pain. Based on disc degeneration and disc rupture, the intervertebral discs were divided into four categories in accordance with the Dallas Discogram Description: Grades 0-3 of both degeneration and rupture.Results. There was a positive correlation between endplate degeneration and disc-degeneration and a positive correlation between disc rupture and pain provocation; but there was no association between endplate degeneration and disc rupture and-no correlation between endplate degeneration and pain provocation on diskography:Conclusions. This study showed a stronger association between endplate degeneration and disc degeneration than between endplate degeneration and disc rupture. The results indicate that the contrast injection during diskography reflects mainly pain of discogenic origin, whereas the possible pain associated with endplate damage cannot be depicted by CT diskography.