Department of Neurology, University of California, Irvine, USA.
Best Pract Res Clin Rheumatol. 2012 Apr;26(2):263-80. doi: 10.1016/j.berh.2012.03.006.
Spinal disorders and especially back and neck pain affect more people and have greater impact on work capacity and health-care costs than any other musculoskeletal condition. One of the difficulties in reducing the burden of spinal disorders is the wide and heterogeneous range of specific diseases and non-specific musculoskeletal disorders that can involve the spinal column, most of which manifest as pain. Despite, or perhaps because of its impact, spinal disorders remain one of the most controversial and difficult conditions for clinicians, patients and policymakers to manage. This paper provides a brief summary of advances in the understanding of back and neck pain over the past decade as evidenced in the current literature. This paper includes the following sections: a classification of spinal disorders; the epidemiology of spine pain in the developed and developing world; key advancements in biological and biomechanical sciences in spine pain; the current status of potential methods for the prevention of back and neck pain; rheumatological and systemic disorders that impact the spine; and evidence-based surgical and non-surgical management of spine pain. The final section of this paper looks to the future and proposes actions and strategies that may be considered by the international Bone and Joint Decade (BJD), by providers, institutions and by policymakers so that we may better address the burden of spine disorders at global and local levels.
脊柱疾病，尤其是背痛和颈痛，比任何其他肌肉骨骼疾病影响更多的人，对工作能力和医疗保健成本的影响也更大。减少脊柱疾病负担的困难之一是涉及脊柱的特定疾病和非特异性肌肉骨骼疾病的广泛和异质范围，其中大多数表现为疼痛。尽管如此，或者因为其影响，脊柱疾病仍然是临床医生、患者和政策制定者最难管理的最具争议性的疾病之一。本文简要总结了过去十年中在理解背痛和颈痛方面的进展，这些进展在当前文献中得到了证明。本文包括以下几部分：脊柱疾病的分类；发达国家和发展中国家脊柱疼痛的流行病学；脊柱疼痛的生物和生物力学科学的主要进展；预防背痛和颈痛的潜在方法的现状；影响脊柱的风湿病和系统性疾病；以及脊柱疼痛的循证手术和非手术治疗。本文的最后一部分着眼于未来，并提出了国际骨骼和关节十年（BJD）、提供者、机构和政策制定者可能考虑的行动和策略，以便我们能够更好地在全球和地方层面解决脊柱疾病的负担。
