Department of Neurosurgery, Wake Forest University School of Medicine, Winston Salem, North Carolina.
Department of Anesthesiology, Wake Forest University School of Medicine, Winston Salem, North Carolina.
Neurosurgery. 2020 Aug 1;87(2):166-175. doi: 10.1093/neuros/nyz573.
Marijuana is increasingly utilized for the treatment of multiple medical problems, including back pain, in the United States. Although there is strong preclinical evidence supporting the promise of cannabinoids in the treatment of back pain, there is a paucity of clinical data supporting their use in clinical practice. Opioids are an important medication for the treatment of acute and chronic back pain, but utilization of opioid-based regimens have likely contributed to the growing opioid epidemic. The significant risk of morbidity, mortality, and dependence secondary to opioid medications have increased the interest in nonopioid medications, including cannabinoid-based pain regimens, in treating back pain. This review will provide an overview on the pharmacology, drug delivery methods, clinical evidence, and safety considerations critical to understanding the potential role of cannabinoids in the treatment of back pain.
在美国，大麻被越来越多地用于治疗多种医学问题，包括背痛。尽管有大量支持大麻素治疗背痛的临床前证据，但支持其在临床实践中应用的临床数据却很少。阿片类药物是治疗急性和慢性背痛的重要药物，但阿片类药物的使用可能导致了阿片类药物流行的加剧。阿片类药物所带来的发病率、死亡率和依赖性的显著风险增加了人们对非阿片类药物的兴趣，包括基于大麻素的疼痛治疗方案，以治疗背痛。这篇综述将提供大麻素治疗背痛的药理学、药物输送方法、临床证据和安全性考虑的概述，这些都是理解大麻素在治疗背痛方面的潜在作用的关键。
