Haldeman S
Department of Neurology, University of California, Irvine, Irvine, California, USA.
Neurol Clin. 1999 Feb;17(1):1-15. doi: 10.1016/s0733-8619(05)70111-0.
It is clear that low back pain is not a simple process that can be explained on purely anatomic, biomechanical, or neurophysiologic theories. The intimate relationship of these processes have to be considered. Each of the potential biomechanical stresses influence the different spinal structures in different ways, depending on the forces applied and the structure being affected. The biomechanical response to the trauma caused by these forces may be immunologic, inflammatory, or neurochemical, depending on the structures being traumatized. Once a nociceptive process is underway, it is greatly influenced by the spinal cord and the brain. Only by following this process through its various steps can a clinician begin to formulate an understanding of the mechanisms involved in the genesis of low back pain.
很明显，腰痛并非一个能用纯粹的解剖学、生物力学或神经生理学理论来解释的简单过程。必须考虑这些过程之间的密切关系。每种潜在的生物力学应力都会以不同方式影响不同的脊柱结构，这取决于所施加的力以及受影响的结构。这些力所造成的创伤引发的生物力学反应可能是免疫性、炎症性或神经化学性的，具体取决于受创伤的结构。一旦伤害感受过程开始，它就会受到脊髓和大脑的极大影响。临床医生只有历经这个过程的各个步骤，才能开始理解腰痛发生机制中所涉及的原理。
