The Clinical Value Of Discography CT Classification In Treating Discogenic Low Back Pain By Radiofrequency Ablation

Objective: To study the clinical value of discography CT classification for treating discogenic low back pain by radiofrequency ablation.Methods:52 patients were diagnosed as discogenic low back pain by X-ray films,MRI,discography and clinical symptoms. Then they received radiofrequency ablation treatment。All of them underwent CT scan after pressure-controlled discography. The images were classified with Dallas criterion. They were followed-up 1 year after operation and The VAS score were recorded at different time of follow-up,including before the operation,one week after operation and one year after operation.The rate of symptom relief(VAS score)and improved Macnab criterion were adopted to evaluate the effect of the radiofrequency ablation and the value of discography CT classification before operation.Results:According to the results of discography,there were 35 single-segment patients and 17 non- single-segment patients in all cases. The results of discography in normal disc were all Dallas0～Ⅰgrade.In the 35 single-segment patients ,eighteen cases were DallasⅡgrade and seventeen cases were DallasⅢgrade. There were significant statistical diference(P<0.05)between the VAS score before operation and one week after operation in 52 cases. There were significant statistical diference(P<0.05)between the VAS score before operation and one year after operation in 52cases.There were no significant statistical diference(t= -1.93,P>0.05)between single-segment group and non- single-segment group before operation;but the VAS score in non-single-segment group was higher than that in single-segment group one week after operation and one year after operation,there were significant statistical diference(respectively t=-2.27,P<0.05; t= -2.65,P<0.05).In the comparison between DallasⅡgrade group and DallasⅢgrade group, there were no significant statistical diference(t= -1.55,P>0.05)before operation; but VAS score in DallasⅢgrade group was higher than that in DallasⅡgrade group one week after operation and one year after operation,there were significant statistical diference(respectively t=-2.40, P<0.05; t= -2.61, P<0.05).Conclusions:⑴Radiofrequency ablation were a safe,minimally invasive,simple,effective treatment for discogenic low back pain.⑵Efficacy in single-segment patients were better than that in the non- single-segment patients . In single-segment cases, efficacy in DallasⅡgrade patients were better than that in the DallasⅢgrade patients.Discography CT classification was valuable for selecting the appropriate case before Radiofrequency ablation.⑶The one-year effect after operation was worse than one-week effect.