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[腰椎间盘突出症——诊断与治疗]

[Lumbar disc herniation--diagnosis and treatment].

作者信息

Corniola M-V, Tessitore E, Schaller K, Gautschi O P

出版信息

Rev Med Suisse. 2014 Dec 10;10(454):2376-82.

Abstract

A lumbar disc herniation (LDH) is a condition frequently encountered in primary care medicine. It may give rise to a compression of one or more nerve roots, which can lead to a nerve root irritation, a so-called radiculopathy, with or without a sensorimotor deficit. The majority of LDHs can be supported by means of a conservative treatment consisting of physical therapy, ergotherapy, analgetics, anti-inflammatory therapy or corticosteroids, which may be eventually administered by infiltrations. If a clinico-radiological correlation is present and moderate neurological deficit appears suddenly, if it is progressive under conservative treatment or if pain is poorly controlled by well-conducted conservative treatment performed during four to six months, surgery is then recommended.

摘要

腰椎间盘突出症(LDH)是基层医疗中常见的病症。它可能导致一个或多个神经根受压,进而引发神经根刺激,即所谓的神经根病,伴有或不伴有感觉运动功能障碍。大多数腰椎间盘突出症可通过保守治疗来缓解,保守治疗包括物理治疗、职业疗法、镇痛药、抗炎治疗或皮质类固醇,最终可能通过局部注射给药。如果存在临床与影像学的相关性,且突然出现中度神经功能缺损,或者在保守治疗过程中病情进展,又或者经过四到六个月规范的保守治疗后疼痛仍控制不佳,那么建议进行手术。

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