Itz Coen J, Willems Paul C, Zeilstra Dick J, Huygen Frank J P M
Erasmus MC, afd. Anesthesiologie-pijngeneeskunde, Rotterdam, the Netherlands.
Ned Tijdschr Geneeskd. 2013;157(32):A6030.
The practice guideline 'Invasive treatment of spine related low back pain' describes the state of the art regarding the diagnosis and value of invasive treatment after failure of conservative treatment in patients with pain symptoms of facet joint pain, pain in the sacroiliac joint, coccygodynia, discogenic pain and the 'failed back surgery syndrome'. There is no consensus on definitions and a classification system for chronic low back pain symptoms. The classification in specific and nonspecific low back pain provides insufficient insight and is unable to show which therapy is effective for which disorder. The guideline working group advises a new classification system for chronic low back pain in degenerative and non-degenerative disorders. After failure of conservative treatment, several specific invasive treatments are recommended; some of these treatments should only be performed in study related settings. Some of the treatments that are currently used in daily practice are inadvisable.
《脊柱相关性下腰痛的侵入性治疗》实践指南描述了在患有小关节疼痛、骶髂关节疼痛、尾骨痛、椎间盘源性疼痛和“腰椎手术失败综合征”疼痛症状的患者中，保守治疗失败后侵入性治疗的诊断现状和价值。对于慢性下腰痛症状的定义和分类系统尚无共识。特定性和非特定性下腰痛的分类提供的见解不足，无法表明哪种疗法对哪种疾病有效。指南工作组建议针对退行性和非退行性疾病的慢性下腰痛采用新的分类系统。保守治疗失败后，推荐了几种特定的侵入性治疗方法；其中一些治疗仅应在研究相关环境中进行。目前日常实践中使用的一些治疗方法是不可取的。
