Bodack M P, Monteiro M
Department of Physical Medicine & Rehabilitation, St Francis Hospital, Poughkeepsie, NY, USA.
Clin Orthop Relat Res. 2001 Mar(384):144-52. doi: 10.1097/00003086-200103000-00017.
Lumbar spinal stenosis is a condition that may cause significant pain and associated disability, especially in older patients. It is being recognized with increasing frequency as the population continues to age, and is the most common diagnosis associated with lumbar spine surgery in patients older than 65 years of age. The natural history of lumbar spinal stenosis is not necessarily one of progressive deterioration. Conservative treatment is advocated in patients with mild to moderate symptoms of lumbar spinal stenosis, and may include therapeutic exercise. The therapeutic exercise program must be prescribed with a thorough understanding of the contributing pathoanatomic and pathophysiologic factors, and should be tailored to each patient based on his or her history and physical examination. Components of the program are described in detail and include specific stretching and strengthening exercises, general conditioning exercises, and education in proper posture and body mechanics. Randomized controlled studies are needed to help clarify the indications for conservative versus surgical treatment, to determine which components of the therapeutic exercise program are the most beneficial, and to compare outcomes after conservative or surgical measures.
腰椎管狭窄症是一种可能导致严重疼痛及相关残疾的病症，在老年患者中尤为常见。随着人口持续老龄化，这种疾病的诊断频率越来越高，并且是65岁以上患者腰椎手术最常见的诊断病因。腰椎管狭窄症的自然病程不一定是进行性恶化。对于有轻至中度腰椎管狭窄症状的患者，提倡保守治疗，可能包括治疗性锻炼。制定治疗性锻炼方案必须充分了解相关的病理解剖和病理生理因素，并应根据每位患者的病史和体格检查进行量身定制。该方案的组成部分将详细描述，包括特定的伸展和强化锻炼、一般的身体调节锻炼以及正确姿势和身体力学的教育。需要进行随机对照研究，以帮助明确保守治疗与手术治疗的适应症，确定治疗性锻炼方案的哪些组成部分最有益，并比较保守治疗或手术治疗后的结果。
