Symptomological diagnosis of discogenic low back pain and its neurological anatomic principle / 中华骨科杂志

ABSTRACT

Objective To analyse the symptoms in discogenic low back pain and their neurological anatomic mechanism,and to explore the theoretical basis of symptomatic diagnosis of discogenic low back pain.Methods From January 2010 to December 2013, 289 patients were primarily diagnosed as discogenic discogenic low pain in our department, of which 164 patients showing only single abnormal segment on MRI were enrolled, including 99 male and 65 female patients, averaging 42 years old.All patients underwent discography.All the symptoms conform to the neurological anatomic mechanism of lumbar disc, i.e.extensive low back pain, posterior ilium pain, lateral thigh pain, groin pain, low abdomen pain, were recorded postoperatively.Then the occurrence rate of each symptom with positive discography was calculated.The positive rate (equal to sensitivity of the symptom to the diagnosis of discogenic low pain) of discography when each symptom occurred and the negative rate (equal to specificity of the diagnosis of the symptom to the discogenic low pain) of discography when each symptom did not occur were calculated respectively.Results The discographies of 129 (78.7％) in 164 patients were positive, of these patients 95 (73.6％) had the symptom of extensive low back pain, 99 (76.7％) had posterior ilium pain, 58 (45.0％) had lateral thigh pain, 29 (22.3％) had groin pain, and 24(18.6％) had low abdomen pain.The positive rate of discography in those with the symptom of extensive low back pain, posterior ilium pain, lateral thigh pain, groin pain and low abdomen pain was 89.6％, 90.8％, 90.6％, 90.6％ and 92.3％ respectively, i.e.the diagnostic sensitivity to the discogenic low back pain of the symptom of extensive low back pain, posterior ilium pain, lateral thigh pain, groin pain and low abdomen pain was 89.6％, 90.8％, 90.6％, 90.6％ and 92.3％ respectively.Conclusion The occurrence of the above-mentioned symptoms in the discogenic low back pain is conform to the neurological anatomic mechanism of efferent nerve of lumbar disc.These symptoms have great diagnostic significance for discogenic low back pain.