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The relative contributions of the disc
and zygapophyseal joint in chronic low back pain. |
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AUTHORS: |
Schwarzer AC; Aprill CN; Derby R; Fortin J;
Kine G; Bogduk N |
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AUTHOR AFFILIATION: |
Faculty of Medicine, University of Newcastle,
Australia. |
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SOURCE: |
Spine 1994 Apr 1;19(7):801-6 |
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CITATION IDS: |
PMID: 8202798 UI: 94261924 |
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ABSTRACT: |
STUDY DESIGN. A prospective cross-sectional analytic approach was
taken. OBJECTIVES. This study sought to determine the relative
contribution of the disc and the zygapophyseal joint as a pain
source in patients with chronic low back pain. SUMMARY OF BACKGROUND
DATA. Previous studies have employed either zygapophyseal joint
blocks or discography, but in no studies have both procedures been
performed. METHODS. Ninety-two consecutive patients with chronic low
back pain were studied using both discography and blocks of the
zygapophyseal joints. RESULTS. Thirty-six patients (39%) had at
least one positive discogram as defined by exact pain reproduction,
an abnormal image, and a negative control. Eight patients responded
to both a screening zygapophyseal joint block using lignocaine and a
confirmatory block using bupivacaine. Only three patients had both a
positive discogram and a symptomatic zygapophyseal joint.
CONCLUSIONS. In patients with chronic low back pain, the combination
of discogenic pain and zygapophyseal joint pain is uncommon. |
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MAIN MESH HEADINGS: |
Intervertebral Disk Displacement/*complications
Low Back Pain/*etiology
*Lumbar Vertebrae |
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ADDITIONAL MESH HEADINGS: |
Adult
Bupivacaine/diagnostic use
Female
Human
Intervertebral Disk/radiography
Intervertebral Disk Displacement/diagnosis
Lidocaine/diagnostic use
Male
Spinal Diseases/complications
Spinal Diseases/diagnosis
Support, Non-U.S. Gov't |
