Schmerztopik bei lumbalen Bandscheibenschäden

Zusammenfassung

Studienziel: Ziel dieser Studie ist es zu klären, wie zuverlässig die in der Literatur angegebenen klassischen Dermatommodelle (Darstellung der Schmerzausstrahlung bei Läsion einzelner Nervenwurzeln) den entsprechenden Segmenten der Lendenwirbelsäule zugeordnet werden können. Methode: Verschiedene Studien, die sich mit bandscheibenbedingten Schmerzprojektionen beschäftigen wurden mittels EDV gesteuerter Literatursuche gefunden und verglichen. Ergebnisse: Bezüglich der Dermatomverläufe im Bereich der unteren LWS gibt es keine eindeutigen Übereinstimmungen. Es besteht ein Widerspruch zwischen der am häufigsten auftretenden Schmerzprojektion (S1) und dem am häufigsten operierten Segment (L4/L5). Schlussfolgerung: Trotz wissenschaftlich fundierter Modelle (Nitta H, Wolff A) ist die Schmerzausstrahlung gegenüber den klassischen Dermatommodellen ein nur bedingt geeigneter Parameter zur Segmentdefinition.

Abstract

Aim: The aim of this study was to find out the reliability of several dermatomic maps (description of pain pattern within a nerve root lesion) according to the respecrive segmental area. Methods: Different studies which deal with pain pattern caused by disc lesions were searched for with MedLine support and then reviewed. Results: A clear correlation between the pain projections of the lumbar spine does not seem to exist. A contradiction of the most common pain projection (S1) and operated disc (L4/5) is described. Conclusion: Even though there are studies of high scientific design and value (Nitta H, Wolff A) the pain pattern of dermatomic maps is only of limited value for the definition of the affected segment.

Schlüsselwörter

Bandscheibenschaden - Lumboischialgie - Dermatommodelle - Schmerzausstrahlung

Key words

disc lesion - sciatica - mapping dermatomes - pain projection

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