Gruber P, Böni T
Klinik für Neurologie, Universitätsspital Zürich, Frauenklinikstrasse 26, 8091, Zürich, Schweiz.
Institut für Evolutionäre Medizin, Universität Zürich, Zürich, Schweiz.
Unfallchirurg. 2015 Dec;118 Suppl 1:43-52. doi: 10.1007/s00113-015-0100-1.
Today, lumbar disc disease is a very common disease, which will be often seen in both the family practice as well as in the consultations of orthopedics, neurology, rheumatology or neurosurgery. Furthermore, lumbar disc surgery is one of the most common spinal surgical procedures worldwide. But, for many centuries, physician had no clear understanding of the anatomical condition and the pathomechanism of this disease. Therefore, no rational treatment was available. The Hippocratic physicians knew the signs and symptoms of lumbar disc disease, which they then called "sciatica". But, they subsumed different disorders, like hip diseases under this term. In the mid-18th century, it was the Italian physician Domenico Felice Antonio Cotugno (1736-1822), who first brought clarity in the concept of radicular syndromes; he recognized, that the so-called "sciatica" could be of neurogenic origin. In 1742, a contemporary of Cotugno, the German Josias Weitbrecht (1702-1747) has to be credited for the first precise description of the intervertebral disc. Nearby a hundred years later, the German Hubert von Luschka (1820-1875) described for the first time a herniated disc in a pathologic specimen. With the landmark report of the New England Journal of Medicine in 1934, the two American surgeons, William Jason Mixter (1880-1958) and Joseph Seaton Barr (1901-1963), finally cleared the pathomechanism of lumbar disc disease.
如今,腰椎间盘疾病是一种非常常见的病症,在家庭医疗以及骨科、神经科、风湿科或神经外科的会诊中都经常能见到。此外,腰椎间盘手术是全球最常见的脊柱外科手术之一。但是,几个世纪以来,医生们对这种疾病的解剖状况和发病机制并没有清晰的认识。因此,没有合理的治疗方法。希波克拉底派的医生们知道腰椎间盘疾病的体征和症状,他们当时称之为“坐骨神经痛”。但是,他们将不同的病症,比如髋关节疾病也归入了这个术语之下。在18世纪中叶,是意大利医生多梅尼科·费利切·安东尼奥·科图尼奥(1736 - 1822)首次明确了神经根综合征的概念;他认识到,所谓的“坐骨神经痛”可能起源于神经。1742年,科图尼奥的同时代人、德国人约西亚斯·魏特布雷希特(1702 - 1747)首次对椎间盘进行了精确描述。将近一百年后,德国人胡贝特·冯·卢施卡(1820 - 1875)首次在病理标本中描述了椎间盘突出。随着1934年《新英格兰医学杂志》具有里程碑意义的报道,两位美国外科医生威廉·贾森·米克斯特(1880 - 1958)和约瑟夫·西顿·巴尔(1901 - 1963)最终厘清了腰椎间盘疾病的发病机制。