【摘要】目的:探讨椎间盘源性腰痛的诊断与治疗方法。方法:回顾性分析2000年10月至2005年5月135例经椎间盘造影(CT)检查诊断为椎间盘源性腰疼痛患者的影像资料。男70例，女65例，年龄23～78岁，平均年龄46.7岁，L3～4 20例，L4～5 70例，L5S1 5例，L3～4与L4～5双间隙10例，L4～5与L5S1双间隙10例。结果:所有患者随访6～26个月，平均18个月，术后腰痛及下肢痛症状明显缓解，均恢复正常生活和工作，VAS评分由术前平均72分，降至术后18分，随访6个月时6.5分。结论:椎间盘源性腰痛由于临床和影像学表现不典型，常被误诊或漏诊，可结合腰椎MRI及椎间盘造影进行诊断，腰椎前路椎间盘切除人工椎间盘置换或椎间cage融合是治疗椎间盘源性腰痛的有效选择。

    【关键词】椎间盘 腰痛 诊断 治疗结果

    Fan ShouhuaPeng jiangxiu,Department of Orthopaedics, Jiangan People's Hospital, YiBing, SiChuan, 644200)

    【Objective】To evaluate the diagnosis and treatment methods ofdiscogenic low back pain. Methods: Twenty-seven patients with chronic low back pain were diagnosed the discogenic low back pain with provocative discography from October 2000 to May 2005,and the radiological data of all cases were retrospectively analyzed. There were 70 males and 65 females with an average age of 46.7 years(ranged 23~78 years) and the level of disc including L3~4 for 20 cases,L4~5 for 70 cases,L5S1 for 25 cases, both L3~4 and L4~5 for 10 cases, both L4~5 and L5S1 for 10 cases.Results: All cases were followed up for 18 months on the average (6~26 months),at the end of follow-up all the patients recovered normal social life and work without any symptoms.VAS decreased from 72 preoperatively to 18 postoperatively,and averaged 6.5 at 6 months after operation. Conclusion with atypical symptom discogenic low back pain which is easily misdiagnosed should always be kept in mind when atypical back and leg pain is encountered. Discography provides good differential diagnosis.Surgical treatment including artifical disc replacement and ALIF provides satisfactory outcome. ......