manuelletherapie 2011; 15(3): 110-116
DOI: 10.1055/s-0031-1273468
Originalarbeit

© Georg Thieme Verlag KG Stuttgart · New York

Schmerzzentralisierung und MRT-Befunde der lumbalen Bandscheiben bei Patienten mit chronischen lumbalen Rückenschmerzen

Pain Centralization and Lumbar Disc MRI Findings in Chronic Low Back Pain PatientsS. Kilpikoski1 , M. Laslett2 , O. Airaksinen3 , M. Kankaanpää4 , M. Alen5
  • 1Dept. of Health Sciences, University of Jyväskylä, FIN-Jyväskylä
  • 2Auckland University of Technology, NZ-Auckland
  • 3Dept. of Physical Medicine and Rehabilitation, Kuopio University Hospital, FIN-Kuopio
  • 4Dept. of Physical Medicine and Rehabilitation, Tampere University Hospital, FIN-Tampere
  • 5Dept. of Medical Rehabilitation, Oulu University Hospital and Institute of Health Sciences, University of Oulu, FIN-Oulu
Further Information

Publication History

Manuskript eingetroffen: 4.10.2010

Manuskript akzeptiert: 20.12.2010

Publication Date:
25 July 2011 (online)

Zusammenfassung

Im Rahmen der Bewertung von lumbalen Rückenschmerzen ist Schmerzzentralisierung ein spezifischer Befund. Ein dynamisches internes „Bandscheibenmodell” mit hoher positiver Korrelation mit Schmerzen während der Provokationsdiskografie wurde als ein der Schmerzzentralisierung zugrunde liegender Mechanismus hypothetisiert. Zwar ergibt die MRT häufig auch bei asymptomatischen Personen strukturelle Abnormalitäten, aber der Zusammenhang zwischen der Zentralisierung bei symptomatischen Personen und der abgebildeten Bandscheibenpathologie wurde bisher nicht evaluiert. Das Ziel dieser Studie bestand darin, den Zusammenhang (kriterienbezogene Validität) zwischen dem Zentralisierungsphänomen und den MRT-Befunden zur Pathologie der Lendenbandscheiben als Kriteriumsstandard bei Patienten mit chronischen lumbalen Rückenschmerzen zu bewerten.

Zwischen Schmerzzentralisierung und Abnormalitäten der LWS-Bandscheiben besteht ein Zusammenhang. Da das Zentralisierungsphänomen stark mit guten Behandlungsergebnissen assoziiert wird, empfiehlt sich vor der Überweisung an einen Chirurgen eine an der Zentralisierung orientierte konservative Behandlung der Bandscheibenpathologie.

Abstract

In the assessment of low back pain (LBP) pain centralization is a specific finding. A dynamic ”internal disc model” has been hypothesized as underlying mechanism for pain centralization, which has shown a high positive correlation with pain during provocation discography. Though structural abnormalities on MRI are common among asymptomatic individuals, the association between centralization among symptomatic individuals with imaged disc pathology has not yet been evaluated. The aim of this study was to estimate the association (criterion-related validity) between the centralization phenomenon and magnetic resonance imaging (MRI) findings of lumbar disc pathology as the criterion standard among chronic low back pain patients.

Pain centralization is associated with abnormalities of lumbar discs. As the centralization phenomenon closely correlates with good treatment outcomes before surgical referral centralization-guided conservative treatment is recommended for disc pathologies.

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Sinikka Kilpikoski

PhD MSc PT, Dept. of Health Sciences, University of Jyväskylä, FIN-Jyväskylä

Savonmäentie 15

40800 VAAJAKOSKI

Finland

Email: sinikka.kilpikoski@kolumbus.fi

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