综述：椎间盘源性背痛：治疗进展
Review: Discogenic Back Pain: Update on Treatment.
作者信息
Remotti Edgar, Nduaguba Chinoso, Woolley Parker A, Ricciardelli Ryan, Phung Anh, Kim Rosa, Urits Ivan, Kaye Alan David, Hasoon Jamal, Simopoulos Thomas, Yazdi Cyrus, Robinson Christopher L
机构信息
Beth Israel Deaconess Medical Center, Department of Anesthesiology, Critical Care, and Pain Medicine, Harvard Medical School, Boston, MA.
Georgetown University Hospital, Department of General Surgery, Medstar, Washington, DC.
出版信息
Orthop Rev (Pavia). 2023 Aug 25;15:84649. doi: 10.52965/001c.84649. eCollection 2023.
PURPOSE OF REVIEW
Lower back pain (LBP) has a lifetime prevalence of 80% in the United States population. Discogenic back pain (DBP), a subcategory of LBP, occurs as a result of the interverbal disc degeneration without disc herniation. Diagnosis relies on history, physical exam, and imaging such as MRI, provocative discography, or CT discography.
RECENT FINDINGS
Treatment of DBP involves a multifaceted approach with an emphasis on conservative measures including behavioral modification, pharmacologic management, and other non-pharmacologic interventions with invasive therapy reserved for select patients. Due to the paucity of data on the treatment of DBP, treatment also relies on data derived from treatment of chronic LBP (CLBP).
SUMMARY
Despite the scarcity of data for the treatment of DBP, treatments do exist with varying efficacy for DBP. Novel techniques such as the use of biologics may provide another avenue for treatment though further studies are needed to better evaluate the most efficacious regimen for both novel and existing treatments.
综述目的
在美国人群中，下背痛（LBP）的终生患病率为80%。椎间盘源性背痛（DBP）是LBP的一个亚类，是由椎间盘退变但无椎间盘突出引起的。诊断依赖于病史、体格检查以及MRI、激发性椎间盘造影或CT椎间盘造影等影像学检查。
最新发现
DBP的治疗采用多方面方法，重点是保守措施，包括行为矫正、药物治疗以及其他非药物干预，仅对特定患者采用侵入性治疗。由于关于DBP治疗的数据匮乏，治疗也依赖于源自慢性下背痛（CLBP）治疗的数据。
总结
尽管DBP治疗的数据稀缺，但确实存在对DBP疗效各异的治疗方法。使用生物制剂等新技术可能提供另一种治疗途径，不过需要进一步研究以更好地评估新老治疗方法中最有效的治疗方案。
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