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腰椎脊柱狭窄症:诊断和管理

Charles W Webb¹, Kenneth Aguirre¹, Peter H Seidenberg¹

¹Louisiana State University Health Science Center School of Medicine, Shreveport, Louisiana.

American family physician

|April 22, 2024

概括

腰椎脊柱狭窄症是老年人慢性腰部疼痛的常见原因,涉及脊柱通道狭窄. 治疗选择范围从保守的护理到手术,当保守的方法失败时.

科学领域:

神经学神经学
整形外科整形外科整形外科
疼痛管理疼痛管理

背景情况:

腰椎脊柱狭窄症 (LSS) 是一种普遍的临床综合征,每年在美国影响超过20万人.
它是慢性,阴险的腰部疼痛的主要原因,特别是在老年人群中 (平均年龄64岁).
脊髓神经硬化是一种退行性脊柱状况,其特征是神经血管束空间缩小,导致双边辐射疼痛.

研究的目的:

为了提供对腰椎脊柱狭窄的全面概述.
讨论LSS的诊断方式和当前的管理策略.
突出各种治疗选择的证据基础.

主要方法:

关于腰椎脊柱狭窄症的文献综述.
对诊断成像技术的分析,重点是MRI.
评估非手术和手术治疗选择.

主要成果:

磁共振成像 (MRI) 是诊断LSS的黄金标准,因为它能够测量脊柱管道尺寸.
非手术干预包括物理治疗,炼,脊髓注射,脊椎治疗,骨科医疗操纵,针和生活方式改变.
高质量的随机试验证明了许多非手术治疗的有效性是有限的.

结论:

腰椎脊柱狭窄症是一种渐进的退行性疾病,需要谨慎管理.
虽然存在各种非手术选择,但它们的有效性通常由有限的高质量证据支持.
当保守治疗证明无效时,就会考虑进行手术干预.

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