Résumé
Un nouveau système de discomanométrie a été développé et évalué afin d'être appliqué au rachis lombaire. La fiabilité diagnostique de la discographie, de la manométrie et de la discomanométrie (combinaison des deux méthodes) en matière de hernie discale, a été évaluée sur 20 rachis lombaires de cadavres (95 disques intervertébraux). La sensibilité était de 92% pour la manométrie et 78% pour la discographie. Cela indique que 22% des disques présentant une hernie ne pouvaient pas être identifiés par la discographie de routine. La spécificité était de 98% pour la manométrie et 100% pour la discographie, indiquant que les disques intacts pouvaient être aisément identifiés par les deux méthodes. Une combinaison de la manométrie et de la discographie assure une grande sensibilité (98%) ainsi qu'une haute spécificité (98%). En conclusion, la discomanométrie est un procédé diagnostique simple, économique et fiable que l'on peut pratiquer avant la nucléotomie percutanée sans risques ni efforts supplémentaires importants. Elle permet de distinguer les disques intervertébraux intacts des disques rompus avec une grande fiabilité diagnostique expérimentale, ce qui justifie son utilisation chez les patients.
Summary
A new discomanometry system was developed and evaluated for application in the lumbar spine. The diagnostic reliability of discography, manometry and discomanometry (a combination of both methods) was assessed in 20 lumbar cadaver spines (95 intervertebral discs) with regard to the diagnosis of non-contained intervertebral discs. The sensitivity was 92% for manometry and 78% for discography. This indicates that 22% of the non-contained discs could not be correctly identified with common discography. The specificity was 98% for manometry and 100% for discography, indicating that contained discs could be easily identified with both methods. A combination of manometry and discography provides a high sensitivity (98%) as well as high specificity (98%). It is concluded that discomanometry is a simple, cost-effective and reliable diagnostic procedure which can precede percutaneous nucleotomy without additional risks or relevant efforts. It allows the differentiation between contained and non-contained intervertrebral discs with a high degree of diagnostic reliability in an experimental setting, which justifies its further application in patients.
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Boos, N., Isotalo, M., Witschger, P. et al. Discomanometry in lumbar intervertebral discs: an experimental study. Eur Spine J 2, 215–222 (1993). https://doi.org/10.1007/BF00299449
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DOI: https://doi.org/10.1007/BF00299449