中文摘要：

目的探讨椎间盘封闭术对纤维环破裂型椎间盘源性腰痛的诊治价值。方法临床高度怀疑椎间盘源性腰痛行椎间盘造影及单个椎间盘封闭术且有完整随访资料的患者120例，男72例，女48例：年龄25-60岁，平均48岁。根据造影术中纤维环破裂Dallas分级将患者分为0级组7例、1级组36例、2级组48例、3级组29例。采用疼痛视觉模拟评分（visual analogue scale，VAS）及罗兰莫里斯功能评分表（Roland Morris Disability Questionnaire，RMDQ）对术前及术后2周、2个月、6个月、12个月及24个月的疗效进行评估。结果对高度怀疑的“责任椎间盘”进行封闭阻滞后患者腰痛症状明显改善，术后疼痛VAS和RMDQ评分与术前比较差异有统计学意义：Dallas3级组中期疗效优于Dallas1级组及2级组，差异有统计学意义；重度纤维环破裂患者（Dallas分级3级）术后各时间点腰痛症状复发率均低于其他各组患者。结论椎间盘封闭术能有效缓解椎间盘源性腰痛的症状，并有一定的诊断价值，可作为造影术不能复制疼痛病例的补充诊断依据；纤维环破裂型椎间盘源性腰痛患者，特别是重度纤维环破裂患者．接受椎间盘局部封闭术后缓解疼痛的效果确切。

英文摘要：

Objective To retrospectively investigate diagnostic and therapeutic value of intradiscal steroid injection in patients with discogenic low back pain combined with radial fissure of annulus fibrosis. Methods Totally 120 patients who had undergone CT guided intervertebral discography and steroid injec-tions, including 72 males and 48 females, aged from 25 to 60 years （average, 48 years）, were recruited to this study. According to Dallas discography description system, 7 cases were rated as grade 0, 36 grade 1, 48 grade 2, and 29 grade 3. The Visual Analogue Scale （VAS） and Roland Morris Disability Questionnaire （RMDQ） were used to evaluate clinical effect at 2 weeks, 2 months, 6 months, 12 months and 24 months postoperatively. Results Most of patients who underwent steroid injection in single highly suspect ＂dis-eased disc＂ claimed significant symptom improvement. There were statistically significant differences be-tween pre-and post-operative VAS and RMDQ. The clinical effect in grade 3 group was better than those in grade 1 and grade 2 groups, and the differences were significant. Patients with severe disc disruption （grade 3） had a lower recurrence rate of low back pain compared with other patients. Conclusion Intradiseal steroid injection not only can significantly relieve discogenic low back pain, but also can benefit diagnosis of discogenic low back pain, especially in patients who fail to reproduce ＂concordant pain＂ on discography. For patients with severe rupture of the annulus fibrosus, the relief of discogenic low back pain is more significant.