Iwatsuki Koichi, Yoshimine Toshiki, Yoshimura Kazuhiro, Ishihara Masahiro, Ohnishi Yu-Ichiro, Goto Yuko
Department of Neurosurgery, Osaka University Medical School, Osaka, Japan.
Clin Med Insights Arthritis Musculoskelet Disord. 2010 Mar 10;3:1-5. doi: 10.4137/cmamd.s3831.
We report a case of intractable chronic low-back pain in a gymnast that was caused by ligamentopathia in the interspinous region of the lumbar vertebrae. Sprained interspinous ligaments are a common mechanical cause of acute low-back pain in athletes. Although conservative therapy is generally effective in such cases, in this case it was not. The patient experienced severe low-back pain during lumbar flexion with tension between the L5/S interspinous ligaments. We performed interspinous fixation by using a spinous process plate system, which has been developed for short in situ fusions, and following which the low-back pain resolved. Conservative therapy for low-back pain caused by ligamentopathia is first-line choice, but interspinous fixation with instrumentation might be recommended in intractable cases with conservative therapy.
我们报告一例体操运动员顽固性慢性下腰痛病例，病因是腰椎棘突间区域的韧带病变。棘突间韧带扭伤是运动员急性下腰痛常见的机械性病因。虽然保守治疗在此类病例中通常有效，但该病例并非如此。患者在腰椎前屈时，L5/S棘突间韧带张力下会出现严重下腰痛。我们使用一种为短节段原位融合开发的棘突间钢板系统进行了棘突间固定，之后下腰痛得以缓解。韧带病变所致下腰痛的保守治疗是首选，但对于保守治疗无效的顽固性病例，可能建议采用器械辅助的棘突间固定。
