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腰椎管狭窄症的疼痛管理干预措施:文献综述

Pain Management Interventions in Lumbar Spinal Stenosis: A Literature Review.

作者信息

Malik Kashif N, Giberson Curren, Ballard Matthew, Camp Nathan, Chan Justin

机构信息

Physical Medicine and Rehabilitation, Casa Colina Hospital, Pomona, USA.

Physical Medicine and Rehabilitation, Western University of Health Sciences, Pomona, USA.

出版信息

Cureus. 2023 Aug 25;15(8):e44116. doi: 10.7759/cureus.44116. eCollection 2023 Aug.

Abstract

Lumbar spinal stenosis (LSS) occurs due to the narrowing of the space within the vertebral canal and or intervertebral foramina. This results in the compression of the spinal cord and possibly the roots of the spinal nerves. Lower back pain and neurogenic claudication (NC) are major symptoms of spinal stenosis. This is a literature review that summarizes the important findings pertaining to pain management of spinal stenosis. Twenty-four original articles were assessed. Pain can be treated through non-invasive or surgical methods. Conservative techniques include physical exercises, epidural corticosteroid injection, local anesthetic injection therapy, and oral analgesics. Surgical intervention deals with the decompression of the affected spinal region, with or without vertebral fusion surgery. Other novel surgical techniques include implantation of specific equipment, known as interspinous spacer devices and minimally invasive lumbar decompression (MILD). Most studies offering a comparative analysis have demonstrated that surgical intervention is more efficacious than non-surgical interventions to manage pain associated with spinal stenosis.

摘要

腰椎管狭窄症(LSS)是由于椎管内和/或椎间孔空间变窄所致。这会导致脊髓以及可能的脊神经根受压。下背痛和神经源性间歇性跛行(NC)是椎管狭窄的主要症状。这是一篇文献综述,总结了与椎管狭窄疼痛管理相关的重要研究结果。共评估了24篇原创文章。疼痛可通过非侵入性或手术方法进行治疗。保守治疗技术包括体育锻炼、硬膜外皮质类固醇注射、局部麻醉注射疗法和口服镇痛药。手术干预是对受影响的脊柱区域进行减压,可进行或不进行椎体融合手术。其他新型手术技术包括植入特定设备,即棘突间撑开装置和微创腰椎减压术(MILD)。大多数提供对比分析的研究表明,在处理与椎管狭窄相关的疼痛方面,手术干预比非手术干预更有效。

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