摘要
背景:椎间盘源性下腰痛是一种椎间盘外周部基本保持完整,而内部各种病理(退变、终板损伤、炎症等)刺激椎间盘内疼痛感受器引起的功能丧失性下腰痛,并且不伴有根性症状,无神经或节段过度活动的放射学证据。目的:综述了椎间盘源性下腰痛病理变化、临床诊断的特异性、敏感性和安全性以及各种诊断方法存在的争议观点。方法:应用计算机检索中国期刊全文数据库、PubMed数据库、EMBASE数据库1970/2010有关椎间盘源性下腰痛诊断的文献,排除重复性研究。结果与结论:共保留42篇文献归纳总结。目前临床上根据椎间盘源性下腰痛的病理变化有多种诊断方法,包括物理检查的中心化趋势和骨震动测试,MRI上的黑间盘、高密度区、Modic改变,椎间盘超声检查,血清学中的高敏感性C-反应蛋白和椎间盘造影。其中腰椎间盘造影有较高的敏感性和特异性,是目前首选的诊断方法。
BACKGROUND：Discogenic low back pain is a loss of lower back function with pain.While the external outline of the disc remains intact,and multiple processes（degeneration,end plate injury,inflammation,etc.） can internally stimulate pain receptors inside the disc without nerve root symptoms.Additionally,there is no root symptom,and no radiological evidence of segmental activities.OBJECTIVE：To overview the pathology,clinical diagnostic specificity,sensitivity and security and controversial point of diagnostic methods on discogenic low back pain.METHODS：The first author searched literatures related to the diagnosis of discogenic low back pain from CNKI,PubMed and EMBASE databases from 1970 to 2010.Repetitive articles were excluded,RESULTS AND CONCLUSION：Totally 42 papers were selected.At present,there are several clinical diagnostic methods of discogenic low back pain according to the pathological changes,including centralization phenomenon and bony vibration test in physical examinations,the ＂dark＂ discs,high-density zones and Modic changes on MRI,discography disc ultrasound examination,and the high-sensitivity C-reactive protein in serology.Lumbar discography which has high sensitivity and specificity is the preferred diagnostic method.
出处
《中国组织工程研究与临床康复》
CAS
CSCD
北大核心
2011年第39期7366-7370,共5页
Journal of Clinical Rehabilitative Tissue Engineering Research
