退行性椎间盘疾病与慢性下腰痛的管理

Management of degenerative disk disease and chronic low back pain.

作者信息

Karppinen Jaro, Shen Francis H, Luk Keith D K, Andersson Gunnar B J, Cheung Kenneth M C, Samartzis Dino

机构信息

Institute of Clinical Sciences, Department of Physical and Rehabilitation Medicine, University of Oulu, Oulu, Finland.

出版信息

Orthop Clin North Am. 2011 Oct;42(4):513-28, viii. doi: 10.1016/j.ocl.2011.07.009.

DOI:10.1016/j.ocl.2011.07.009

PMID:21944588

Abstract

Degenerative disk disease is a strong etiologic risk factor of chronic low back pain (LBP). A multidisciplinary approach to treatment is often warranted. Patient education, medication, and cognitive behavioral therapies are essential in the treatment of chronic LBP sufferers. Surgical intervention with a rehabilitation regime is sometimes advocated. Prognostic factors related to the outcome of different treatments include maladaptive pain coping and genetics. The identification of pain genes may assist in determining individuals susceptible to pain and in patient selection for appropriate therapy. Biologic therapies show promise, but clinical trials are needed before advocating their use in humans.

摘要

椎间盘退变疾病是慢性下腰痛（LBP）的一个重要病因风险因素。通常需要采用多学科方法进行治疗。患者教育、药物治疗和认知行为疗法对于慢性下腰痛患者的治疗至关重要。有时也主张通过手术干预并配合康复方案。与不同治疗结果相关的预后因素包括适应不良的疼痛应对方式和遗传因素。疼痛基因的识别可能有助于确定易患疼痛的个体，并有助于选择合适治疗方法的患者。生物疗法显示出前景，但在主张将其用于人类之前还需要进行临床试验。