腰椎间盘突出症
Lumbar Disc Herniation.
作者信息
Amin Raj M, Andrade Nicholas S, Neuman Brian J
机构信息
Department of Orthopaedic Surgery, Johns Hopkins Hospital, Baltimore, MD, USA.
Johns Hopkins University School of Medicine, Baltimore, MD, USA.
出版信息
Curr Rev Musculoskelet Med. 2017 Dec;10(4):507-516. doi: 10.1007/s12178-017-9441-4.
PURPOSE OF REVIEW
Substantial advancements have been made in the cause, diagnosis, imaging, and treatment options available for patients with lumbar disc herniation (LDH). We examined the current evidence and highlight the concepts on the frontline of discovery in LDH.
RECENT FINDINGS
There are a myriad of novel etiologies of LDH detailed in recent literature including inflammatory factors and infectious microbes. In the clinical setting, recent data focuses on improvements in computer tomography as a diagnostic tool and non-traditional injection options including tumor necrosis alpha inhibitors and platelet-rich plasma. Operative treatment outcomes have focused on minimally invasive endoscopic approaches and demonstrated robust 5-year post-operative outcomes. Advances in the molecular etiology of LDH will continue to drive novel treatment options. The role of endoscopic treatment for LDH will continue to evolve. Further research into10-year outcomes will be necessary as this surgical approach continues to gain widespread popularity.
综述目的
在腰椎间盘突出症（LDH）患者的病因、诊断、影像学及治疗选择方面已取得了重大进展。我们审视了当前的证据，并着重介绍了LDH前沿研究中的概念。
最新发现
近期文献详细阐述了LDH的众多新病因，包括炎症因子和感染微生物。在临床方面，近期数据聚焦于计算机断层扫描作为诊断工具的改进，以及非传统注射疗法，如肿瘤坏死因子α抑制剂和富血小板血浆。手术治疗结果主要关注微创内镜手术方法，并显示出稳健的术后5年疗效。LDH分子病因学的进展将继续推动新的治疗选择。内镜治疗LDH的作用将持续演变。随着这种手术方法越来越普及，有必要进一步研究其10年疗效。
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