title: [The clinical research of the relation between the pain and the disc herniation type].
abstract: OBJECTIVE
  To evaluate the preoperative pain degree of lumbar intervertebral disc herniation and analyzed its reason.
  
  
  METHODS
  From January 2002 to December 2008,265 patients with lumbar intervertebral disc herniation were operated by single segment, of which site in L4,5 was 128 cases and in L5S1 was 137 cases. There were 162 males and 103 female, ranging in age from 21 to 78 years, with an average of 46.3 years. Oswestry index of all patients was observed before operation. The patients were divided into five groups based on Carragee system (according to degree of nucleus pulposus herniation and degree of fibrous ring cleavage to group, prolapse and liberation of nucleus pulposus with small ring cleavage was group I; prolapse and liberation with large ring cleavage was group II; contained fragment with integrated fibrous ring was group III; no contained fragment with integrated fibrous ring was group IV; calcified nucleus pulposus with degenerative fibrous ring was group V). The associativity between five types of lumbar intervertebral disc herniation and preoperative pain degree was analyzed.
  
  
  RESULTS
  The preoperative pain in group I and group II was more severe than that of other groups (P<0.01). The preoperative pain in group II was more severe than that of group I (P<0.01).
  
  
  CONCLUSIONS
  Nucleus pulposus can migrated into the spinal canal and will aggravate the nerve root pain if lumbar intervertebral disc herniation accompanies with fibrous ring cleavage; and freed materials can aggravate the nerve root pain by the chemical factor.
authors.affiliation: Department of Orthopaedics, Shengjing Hospital Affiliated to China Medical University, Shenyang 110004, Liaoning, China. heming56@sohu.com
authors.forename: Ming
authors.initials: M
authors.lastname: He
authors.forename: Guang-bin
authors.initials: GB
authors.lastname: Wang
authors.forename: Jia-shi
authors.initials: JS
authors.lastname: Wang
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D007405:Intervertebral Disc Displacement / Q000150:complications* / Q000503:physiopathology / Q000601:surgery; D008159:Lumbar Vertebrae / Q000503:physiopathology / Q000601:surgery; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000150:complications*; D057234:Preoperative Period; D016896:Treatment Outcome; D055815:Young Adult