Boos N, Kissling R
Wirbelsäulenchirurgie, Orthopädische Universitätsklinik Balgrist, Zürich.
Praxis (Bern 1994). 1999 Feb 18;88(8):305-13.
The diagnostic assessment of the low back pain patient is often unsatisfactory because a clear morphological alteration explaining the patient's symptoms can only be found in 10-20% of the cases. The majority of the patients is suffering from non-specific low back pain. However, the high incidence of benign, self-limiting low back pain leads to the risk of overlooking specific causes such as tumor or infection. Similarly, relevant paresis and bladder and bowel dysfunction must be diagnosed in time. Furthermore, the aim of the diagnostic work-up is to diagnose and treat specific causes of back and leg pain (e.g. disc herniation and spinal stenosis) to avoid chronicity. In the majority of the cases, history and clinical examination alone allow to differentiate between specific and non-specific low back pain and may lead to a further diagnostic work-up by imaging studies.
对腰痛患者的诊断评估往往不尽人意，因为只有10%至20%的病例能找到明确解释患者症状的形态学改变。大多数患者患有非特异性腰痛。然而，良性、自限性腰痛的高发病率导致有忽视肿瘤或感染等特定病因的风险。同样，必须及时诊断出相关的轻瘫以及膀胱和肠道功能障碍。此外，诊断检查的目的是诊断和治疗腰腿痛的特定病因（如椎间盘突出和椎管狭窄）以避免病情慢性化。在大多数情况下，仅通过病史和临床检查就能区分特异性和非特异性腰痛，并可能进而通过影像学检查进行进一步的诊断。
