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JOURNAL ARTICLE
RESEARCH SUPPORT, NON-U.S. GOV'T
The relative contributions of the disc and zygapophyseal joint in chronic low back pain.
Spine 1994 April 2
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.
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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