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Local Anesthetics: Clinical Application as Spinal Anesthesia01:11

Local Anesthetics: Clinical Application as Spinal Anesthesia

Spinal anesthetics are given during lower abdomen and limb surgeries to block sensory and motor neurons. They are administered in the mid to low lumbar regions, primarily acting on the cauda equina's nerve roots. The blockade level depends on the local anesthetic (LA) concentration. Usually, low LA concentrations are sufficient to block sensory fibers, while only high LA concentrations block motor fibers. Other factors like injection volume and speed, the patient's posture, and the drug...
Herniated Intervertebral Disc l: Introduction01:29

Herniated Intervertebral Disc l: Introduction

Intervertebral disc herniation refers to the displacement of the nucleus pulposus (the gel-like inner core of the disc) through a tear or weakened area in the annulus fibrosus (the outer fibrous ring). The displaced disc material extends beyond the normal boundaries of the disc space and may compress or irritate nearby spinal nerve roots or, less commonly, the spinal cord.Etiology and Risk FactorsHerniation commonly results from degeneration, in which aging reduces disc hydration and...
Muscles of the Vertebral Column01:27

Muscles of the Vertebral Column

The back muscles that lie deep into the thoracolumbar fascia are called intrinsic or true back muscles. These muscles are divided into four layers: superficial, intermediate, deep, and deepest layers.
Superficial Layer:
The superficial layer consists primarily of the splenius muscles, which include the splenius capitis and splenius cervicis. These muscles are mainly responsible for the head and cervical spine movements, including extension, rotation, and lateral bending. The splenius capitis...
Local Anesthetics: Clinical Application as Epidural Anesthesia01:29

Local Anesthetics: Clinical Application as Epidural Anesthesia

Epidural anesthetics are administered in the fat-filled epidural space, the outermost part of the spinal canal. This technique is commonly employed for pain management and anesthesia during lower abdomen and pelvis surgeries or labor and delivery.
Since epidural anesthetics can be infused through an epidural catheter, all types of drugs, including short-acting ones, can be administered. Chloroprocaine and lidocaine are examples of short and long-duration anesthetics, respectively. Bupivacaine...
Degenerative Disc Disease I: Introduction01:27

Degenerative Disc Disease I: Introduction

Degenerative disc disease is a chronic condition in which intervertebral discs gradually lose structure and function. It is not infectious or autoimmune; rather, it results from age-related biochemical and mechanical changes, influenced by genetic, metabolic, and environmental factors.Structure and Function of DiscsThe spine contains 23 intervertebral discs that absorb load, distribute forces, maintain spacing, and allow flexibility. Each disc consists of a nucleus pulposus, a gel-like core...
Degenerative Disc Disease ll: Pathophysiology01:23

Degenerative Disc Disease ll: Pathophysiology

The symptoms of degenerative disc disease arise from a combination of mechanical compression, vascular compromise, and biochemical inflammation, which together disrupt nerve function and produce pain.Mechanical CompressionDisc degeneration reduces height and elasticity, predisposing to herniation of the nucleus pulposus, a major cause of radicular pain. Herniations may be protrusion (bulging with intact annulus), extrusion (nucleus extends beyond disc but remains connected), or sequestration...

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Updated: May 28, 2026

Biomechanical Changes Related to Low Back Pain: An Innovative Tool for Movement Pattern Assessment and Treatment Evaluation in Rehabilitation
06:28

Biomechanical Changes Related to Low Back Pain: An Innovative Tool for Movement Pattern Assessment and Treatment Evaluation in Rehabilitation

Published on: December 13, 2024

非特異的腰痛 腰痛の特異性のない腰痛

Federico Balagué1, Anne F Mannion, Ferran Pellisé

  • 1Department of Rheumatology, Physical Medicine, and Rehabilitation, Hôpital Fribourgeois-Hôpital cantonal, Fribourg and Geneva University, Geneva, Switzerland. balaguef@h-fr.ch

Lancet (London, England)
|October 11, 2011
PubMed
まとめ

非特異的な腰痛は,多くの成人に影響する世界的な健康問題です. 経営陣は,自己ケアとエビデンスベースのアプローチを優先し,不必要な手術や過剰な治療を避けるべきである.

科学分野:

  • 公衆衛生は公衆衛生である.
  • エピデミオロジー エピデミオロジー
  • 運動器系障害 運動器系障害

背景:

  • 非特異的な腰痛 (NLBP) は,世界的な公衆衛生上の重要な懸念事項です.
  • 生涯の流行率は84%,慢性的な症例は23%で,人口の11-12%で障害を引き起こす.
  • 機械的な要因はそれほど重要ではないが,遺伝的傾向はNLBPにおいて重要な役割を果たしている.

研究 の 目的:

  • 非特異的な腰痛の概要を提供するために.
  • 腰痛の診断と管理戦略について話し合います.
  • 根拠に基づいた,患者中心のケアを強調する.

主な方法:

  • 病歴と臨床検査を重視した診断ガイドラインのレビュー.
  • 診断における臨床画像の使用を制限する勧告.
  • 治療のための臨床的証拠と並行して,患者の好みを考慮すること.

主要な成果:

  • 機械的要因の病原性役割は小さいが,遺伝的要因は重要だ.
  • 多くの治療法の効果の大きさは低く,その作用メカニズムはしばしば不明である.
  • サポートによる自己管理は,通常,外科手術や過剰治療よりも推奨されます.

関連する実験動画

Last Updated: May 28, 2026

Biomechanical Changes Related to Low Back Pain: An Innovative Tool for Movement Pattern Assessment and Treatment Evaluation in Rehabilitation
06:28

Biomechanical Changes Related to Low Back Pain: An Innovative Tool for Movement Pattern Assessment and Treatment Evaluation in Rehabilitation

Published on: December 13, 2024

結論:

  • 非特異的な腰痛は,保守的,エビデンスベースの管理への移行を必要とします.
  • 定期的なイメージングを制限し,過剰な治療を避けるのは非常に重要です.
  • 患者の自己管理を通じたエンパワーメントは,この広範な健康問題に取り組むための鍵です.