文档介绍：间盘源性腰痛- 复制疼痛好还是抑制疼痛好?
刘宪义
北京大学第一医院
DEFINITION:
DBP(discogenic back pain ):伴或不伴下肢放射痛的慢性腰痛,起自椎间盘本身,由椎间盘内部正常结构破坏和生化改变引起的腰痛或放射痛
椎间盘内破裂
(IDD Internal Disc Disrupation / Derangement)
纤维环放射状撕裂 Radial Tear of annulus
痛性纤维环撕裂 Painful Annulus Tear
痛性椎间盘病 Pain Dark Disc Disease
退变性椎间盘疾病(DDD Degenerative Disc Disease)
腰椎僵硬 Lumbar Spondylosis
孤立性椎间盘吸收 Isolated Disc Resorption
节段不稳(Segmental Instability)
Zdeblick classification:
IDD account for 39% of DBP
Thomas A. Zdeblick, MD
The Spine 4th edition 750
The concept of “internal disruptions” was proposed by Crock, in 1970 and 1986.
Low back pain may occurred without nerve pression.
IDD(Internal Disc Disrupation / Derangement)
0—Normal
1—Contrast agent infiltrate to inner 1/3 of Annulus
2—Contrast agent infiltrate to outer 1/3 of Annulus
3—Contrast agent  infiltrate across the outer annulus
CTD shows grade 2 may inducing pain!
Dallas classification of Annulus rupture by CTD
Modified Dallas Discogram
Pathogenesis:
椎间盘造影术后的CT轴向扫描
Pathogenesis:
Pathogenesis:
Granulation tissue
SP--
Pathogenesis:
SP--