Application of lumbar discography in the diagnosis and treatment of the discogenic lumbodynias / 中国骨伤

ABSTRACT

<p><b>OBJECTIVE</b>To explore the diagnostic value of lumbar disc imagery applied for patients with discogenic lumbodynias and the outcome of lumbar fusion and the significance of the imagery technique in choosing the joints and sections for fusion.</p><p><b>METHODS</b>The lumbar imagery technique was applied for 35 patients who suffered from discogenic lumbodynias, involving 74 discs. All the cases got MRI and CT scanning. The results of the imagery and MRI were observed and induced pains were recorded. According to the imagery results, 20 out of the 35 patients received lumbar fusion and were followed up.</p><p><b>RESULTS</b>Among 35 patients, the induced pains occurred at 22 discs in 20 patients (57.1%). All the 22 segments in 20 patients with positive reaction were given lumbar fusion. The follow-up time was 10 months to 2 years with an average of 15 months. Based on the renewed MacNab standard, the results were excellent in 13 cases,good in 4 cases, fair in 2 cases, bad in 1 case. Fifteen patients with negative reaction were given conservative treatment and pains disappeared completely in 5 patients, disappeared nearly in 7 patients, no changes or became worse in 3 patients. Six patients including 9 lumbar discs neighboring the fusion segments who were found no changes in MRI scan and no induced pains in lumbar discography, were not given fusion treatment. Meantime, 1 patient was given fusion treatment because his neighboring symptom-free discs getting more deteriorative resulted in the happen of serious symptoms.</p><p><b>CONCLUSION</b>Lumbar imagery technique has its unique value in the diagnosis and selective treatment of lumbar-disc-related pains. Lumbar fusion of the intervertebral space causing pains can eliminate the suffering of patients. It is appropriate to select those deteriorating discs with symptoms in deciding the fusion segments.</p>