ID | 111145 |
著者 |
Jha, Subash C.
Tokushima University
福田, 昇司
Tokushima University
長町, 顕弘
Tokushima University
|
キーワード | High-intensity zone
Magnetic resonance images
Discography
Percutaneous endoscopic discectomy
Thermal annuloplasty
|
資料タイプ |
学術雑誌論文
|
抄録 | High-intensity zone (HIZ) was originally described as a high-intensity signal on T2-weighted magnetic resonance (MR) images, located in the posterior annulus fibrosus, clearly separated from the nucleus pulposus. Among symptomatic patients with low back pain, HIZ is present in 28-59% of cases. In morphologically abnormal discs, high sensitivity and specificity of 81% and 79%, respectively, were reported for HIZs and concordant pain during discography. In contrast, another report indicated low rates. Although most papers reported high sensitivity and specificity for this relationship, it remains controversial. Regarding the pathology of HIZs, inflammatory granulation tissues are found at sites showing HIZs. Such inflammatory tissues produce pro-inflammatory cytokines and mediators, which sensitize the nociceptors within the disc and cause pain. An effective treatment for this condition is yet to be established. Recently, minimally invasive surgery using percutaneous endoscopic discectomy (PED) under local anesthesia was introduced. After removal of the degenerated disc material, the HIZ is identified with the endoscope and then coagulated and modulated with a bipolar radio pulse. This technique is called thermal annuloplasty. In conclusion, HIZs is an important sign of painful intervertebral disc disruption, if identified precisely based on factors such as location and intensity.
|
掲載誌名 |
The Journal of Medical Investigation
|
ISSN | 13496867
13431420
|
cat書誌ID | AA11166929
AA12022913
|
出版者 | Faculty of Medicine Tokushima University
|
巻 | 63
|
号 | 1-2
|
開始ページ | 1
|
終了ページ | 7
|
並び順 | 1
|
発行日 | 2016-02
|
EDB ID | |
出版社版DOI | |
出版社版URL | |
フルテキストファイル | |
言語 |
eng
|
著者版フラグ |
出版社版
|
部局 |
病院
医学系
|