Pain Provocation and Disc Degeneration in Lumbar Discography. |
Ko, Hyun Yoon , Park, Jae Heung , Kim, Hoon , Yang, Jin Hwan |
1Department of Rehabilitation Medicine, Pusan National University College of Medicine, Korea. drjhyang@medimail.co.kr 2Hyo Jung Rehabilitation Hospital, Korea. |
요추의 추간판조영술에 의한 유발통증과 추간판 변성 |
고현윤, 박재흥, 김훈1, 양진환 |
부산대학교 의과대학 재활의학교실, 1효정재활병원 |
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Abstract |
Objective To determine the relationship between pain prov- ocation and level and disc degeneration in lumbar discography. Method Seventy-one patients with lumbar discogenic pain and total 109 discography were studied. During contrast mediun injection, the patient's pain response was reported. The patients were invited to choose among the following options: 'no pain or only pressure feeling', 'dissimilar', 'similar', and 'exact'. And pain location was chosen among the followings: 'low back', 'buttock', 'anterior thigh', 'posterior thigh', and 'lateral thigh'. Correlation between degeneration and provocation response was analyzed. And discography level and provocation area were evaluated.
Results Low back and buttock area was the most common provocation pain site, but it was not specific by disc level. And provocation pain frequently appeared in irregular and fissured types, but the existence of provocation pain was significantly low in ruptured type.
Conclusion There was no correlation between provocation pain area and discography level. And existence rate of provocation pain in ruptured disc was very low. It might be due to low mechanical compression with little stimulation of nociceptor. We suggested that if patients have a ruptured disc with chemical irritation, provocation pain was not a good indicator of diagnosis of discogenic back pain.
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Key Words:
Discography, Provocation pain, Disc degeneration |
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