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下腰痛伴椎管狭窄的表现、诊断和治疗:叙述性综述。

Presentation, Diagnosis, and Management of Lower Back Pain Associated with Spinal Stenosis: A Narrative Review.

机构信息

Department of Histology, Cytophysiology and Embryology, Academy of Silesia, Katowice, Poland.

Department of Neurosurgery, Szpital sw. Rafała in Cracow, Cracow, Poland.

出版信息

Med Sci Monit. 2023 Feb 23;29:e939237. doi: 10.12659/MSM.939237.

Abstract

Lower back pain (LBP) is an extremely common symptom experienced by people of all ages and is also one of the most frequent causes of disability worldwide. This article aims to review the presentation, diagnosis, and management of lower back pain associated with spinal stenosis. The paper we prepared was classified as a "literature narrative review." Nonetheless, when searching for manuscripts included in our work and reviewing them critically, we concentrated on the keywords: "lower back pain", "lumbar spine stenosis", "diagnostic", "rehabilitation", "neurosurgery", "spine", and "elderly". The incidence of chronic lower back pain (CLBP) increases linearly starting with the third decade of life until 60 years old, and it more often affects women. The course of non-specific LBP above all depends on factors not connected with the spine, which include psychological, behavioral, and social factors, determined by the way the condition is perceived by the patient the environment. Lumbar spine stenosis (LSS) is an age-related process of degeneration of the intervertebral discs, ligamentum flavum, and facet joints, which results in narrowing of the space around the neurovascular structures of the spine. Diagnosis of spinal pain syndromes includes radiography (RTG), computed tomography (CT), and magnetic resonance imaging (MRI). Based on the results of imaging studies, neurological examination, and the severity of the disease, treatment can consist of analgesics and rehabilitation, or, when conservative methods are insufficient, surgical treatment is indicated.

摘要

下腰痛(LBP)是一种极其常见的症状,可发生于各个年龄段的人群,也是全球范围内导致残疾最常见的原因之一。本文旨在综述与椎管狭窄相关的下腰痛的表现、诊断和治疗。我们准备的论文被归类为“文献叙述性综述”。然而,在搜索并批判性地审查我们工作中包含的手稿时,我们专注于以下关键词:“下腰痛”、“腰椎管狭窄”、“诊断”、“康复”、“神经外科”、“脊柱”和“老年人”。慢性下腰痛(CLBP)的发生率从 30 岁开始呈线性增加,直到 60 岁,并且更常影响女性。非特异性 LBP 的病程主要取决于与脊柱无关的因素,包括心理、行为和社会因素,这些因素取决于患者对环境的感知方式。腰椎管狭窄症(LSS)是一种与年龄相关的椎间盘、黄韧带和小关节退行性变过程,导致脊柱神经血管结构周围的空间变窄。脊柱疼痛综合征的诊断包括放射摄影(RTG)、计算机断层扫描(CT)和磁共振成像(MRI)。根据影像学研究、神经学检查和疾病的严重程度,治疗可以包括镇痛和康复,或者在保守方法不足时,需要进行手术治疗。

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