Lively Mathew W, Bailes Julian E
Department of Internal Medicine, West Virginia University, Morgantown, WV, 26506, USA.
Phys Sportsmed. 2005 Apr;33(4):21-7. doi: 10.3810/psm.2005.04.71.
Managing acute lumbar disk herniations in active patients can be challenging for physicians, especially when controversies surrounding treatment options make choosing the right care more difficult. The prognosis for lumbar disk herniations is generally favorable, and most patients will improve with conservative measures, such as early activity and avoiding bed rest. Minimally invasive techniques, such as percutaneous diskectomy, laser diskectomy, and epidural corticosteroid injection, may help control sciatic pain. Athletes who sustain late-season disk injuries should receive conservative treatment before considering surgery. Those who have early-season injuries may be able to return to competition sooner by having a microdiskectomy before a full course of conservative therapy is completed, but data supporting this approach are currently lacking.
对于活跃患者的急性腰椎间盘突出症进行管理，对医生来说可能具有挑战性，尤其是当围绕治疗选择的争议使选择正确的治疗更加困难时。腰椎间盘突出症的预后通常较好，大多数患者通过早期活动和避免卧床休息等保守措施会有所改善。微创技术，如经皮椎间盘切除术、激光椎间盘切除术和硬膜外皮质类固醇注射，可能有助于控制坐骨神经痛。在赛季后期发生椎间盘损伤的运动员在考虑手术之前应接受保守治疗。那些在赛季早期受伤的运动员，在完成整个保守治疗疗程之前进行显微椎间盘切除术，可能能够更快地重返比赛，但目前缺乏支持这种方法的数据。
