Swezey R L
Arthritis & Back Pain Center, Santa Monica, CA.
Geriatrics. 1988 Feb;43(2):39-44.
Low back pain occurs in 90% of the adult population. Previous episodes of low back pain in young adults predisposes to exacerbations and chronic problems in the elderly. Radiographic abnormalities demonstrating osteoarthrosis of the lumbar spine and facet joints and varying degrees of disk bulge and disk degeneration are the rule in both asymptomatic and symptomatic patients. Therefore, clinical assessments rather than purely morphological assessments are necessary to assess treatment plans and prognosis in elderly low back pain patients. Osteoarthritic changes are more often asymptomatic than symptomatic. CT and MRI demonstrations of spinal stenosis should be correlated with clinical findings to determine appropriate management decisions. Most elderly patients with low back pain with or without sciatica and with only radiographic CT or MRI rather than clinical evidence of spinal stenosis can be successfully managed conservatively.
90%的成年人会出现腰痛。年轻人之前的腰痛发作易导致老年人病情加重和出现慢性问题。在无症状和有症状的患者中，显示腰椎和小关节骨关节炎以及不同程度椎间盘膨出和椎间盘退变的影像学异常很常见。因此，对于老年腰痛患者，评估治疗方案和预后需要进行临床评估而非单纯的形态学评估。骨关节炎改变通常无症状而非有症状。脊柱狭窄的CT和MRI表现应与临床 findings相关联，以确定合适的管理决策。大多数有或没有坐骨神经痛、仅有影像学CT或MRI而非脊柱狭窄临床证据的老年腰痛患者可以通过保守治疗成功管理。 （注：原文中“clinical findings”未翻译完整，可补充“临床症状”等表述使译文更通顺）
