Literature DB >> 8202798

The relative contributions of the disc and zygapophyseal joint in chronic low back pain.

A C Schwarzer1, C N Aprill, R Derby, J Fortin, G Kine, N Bogduk.   

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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Year:  1994        PMID: 8202798     DOI: 10.1097/00007632-199404000-00013

Source DB:  PubMed          Journal:  Spine (Phila Pa 1976)        ISSN: 0362-2436            Impact factor:   3.468


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