Jeanneret B, Frey D, Schären S
Orthopädische Universitätsklinik, Felix-Platter-Spital, Basel.
Schweiz Med Wochenschr. 1998 May 2;128(18):706-18.
Low-back pain is a very common disease in Switzerland as elsewhere, with a prevalence of 65%. The pain is usually due to degeneration of the motion segment, but subsides spontaneously in some 95% of cases irrespective of the treatment. Only 5% of patients still have pain after one year; but account for over 80% of the costs due to low-back pain. Some patients can be helped by surgical fusion; however; preoperative identification of the pain source is mandatory. Since there is no consistent correlation between pain and the degree of degeneration of motion segments as seen on plain radiographs, functional radiographs, CT scan or MRI, other diagnostic methods such as facet blocks, discography and external diagnostic fixation must be used. After careful patient selection a fusion operation may be considered. Good results after fusion operations are reported in 60-80% of patients. The operative techniques are described.
与其他地方一样，下背痛在瑞士是一种非常常见的疾病，患病率为65%。疼痛通常是由于运动节段退变所致，但约95%的病例无论接受何种治疗都会自行缓解。只有5%的患者在一年后仍有疼痛；但却占了下背痛相关费用的80%以上。一些患者可通过手术融合得到帮助；然而，术前确定疼痛来源是必不可少的。由于在X线平片、功能位X线片、CT扫描或MRI上所显示的疼痛与运动节段退变程度之间没有一致的相关性，因此必须使用其他诊断方法，如小关节阻滞、椎间盘造影和外固定诊断。在仔细选择患者后，可考虑进行融合手术。据报道，60 - 80%的患者在融合手术后效果良好。文中描述了手术技术。
