腰椎间盘突出症合并神经根病变的诊疗:NASS循证医学指南解读

The diagnosisand treatment of lumbar disc herniation with radiculopathy:interpretation of NASS guidelines for evidence-based medicine

腰椎间盘突出症合并神经根病变(lumbar disc herniation with radiculopathy)是以腰痛和下肢放射痛为主要表现的临床常见疾病。2013年北美脊柱协会(NASS)发布了新版腰椎间盘突出症合并神经根病变的临床指南,该指南通过对文献的系统评价和循证医学证据分析来确定不同的推荐强度,着重讨论在诊断和治疗中常见的问题,提供最佳、有效的诊断及临床诊疗方案。本文在全面解读最新版诊疗指南的基础上,结合我国临床实践,提出临床和研究建议。

Objective:Lumbar disc herniation with radiculopathy refers to a localized displacement of disc material beyond the normal margins of the intervertebral disc space resulting in pain,weakness or numbness in a myotomal or dermatomal distribution.North American Spine Society(NASS)released a new version of clinical guidelines for diagnosis and treatment of lumbar disc herniation with radiculopathy.For providing the best and effective diagnosis and treatment plan,this guidelines use a systematic review of literature and evidence-based medical evidence analysis to identify different recommended intensities,and focus on the common problems of diagnosis and treatment.Thisarticlegivesa brief explanation of guidelines with the clinical practice in China,so as to provide a reference for clinicians and researchers.