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腰椎间盘突出症:诊断与管理。

Lumbar Disc Herniation: Diagnosis and Management.

机构信息

Department of Orthopaedic Surgery, Warren Alpert Medical School, Brown University, Providence, RI; Department of Orthopaedic Surgery, Louisiana State University Health Sciences Center, Shreveport.

Warren Alpert Medical School, Brown University, Providence, RI.

出版信息

Am J Med. 2023 Jul;136(7):645-651. doi: 10.1016/j.amjmed.2023.03.024. Epub 2023 Apr 17.

Abstract

Lumbar disc herniations are common causes of lower back pain, neurological dysfunction, and buttock/leg pain. Herniation refers to the displacement of the nucleus pulposus of the intervertebral disc through the annulus fibrosus, thereby causing pressure on the neural elements. The sequalae of lumbar disc herniations range in severity from mild low back and buttock pain to severe cases of inability to ambulate and cauda equina syndrome. Diagnosis is achieved with a thorough history and physical examination along with advanced imaging. Treatment plans are dictated by corresponding patient symptoms and examination findings with their imaging. Most patients can experience relief with nonsurgical measures. However, if symptoms persist or worsen, surgery may be appropriate.

摘要

腰椎间盘突出症是引起下腰痛、神经功能障碍和臀部/腿部疼痛的常见原因。突出是指椎间盘的髓核通过纤维环移位,从而对神经组织造成压迫。腰椎间盘突出症的后遗症从轻度下腰痛和臀部疼痛到严重的无法行走和马尾综合征不等。通过详细的病史和体格检查以及高级影像学检查来确诊。治疗方案取决于相应的患者症状和检查结果及其影像学检查。大多数患者可以通过非手术治疗缓解症状。然而,如果症状持续或恶化,手术可能是合适的选择。

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