椎间盘源性腰痛诊疗进展

Progress in the diagnosis and treatment of discogenic low back pain

腰痛作为临床常见疾病,严重影响着人们的工作生活。椎间盘源性疼痛(discogenic low back pain,DLBP)被认为是引起腰痛主要病因之一,但由于其临床表现不典型,如何明确诊断长期困扰着临床医生。磁共振成像(magnetic resonance imaging,MRI)是常用检查手段之一,但研究发现MRI仅能作为诊断DLBP的提示和筛查影像学指标。椎间盘造影被认为是诊断的金标准,但近年研究发现造影本身可能会增加椎间盘的退变和突出的风险。DLBP的治疗方法也较为多样:保守治疗、手术治疗以及新兴的生物治疗等,但大多数方法的效果尚不明确,需要更多的临床研究来验证。本文通过回顾分析近年国内外文献,将DLBP发病机制、诊断及治疗最新进展进行综述。

Lumbago,as a common clinical disease,seriously affects people's work and life.iscogenic low back pain(DLBP)is considered to be one of the main causes of low back pain.However,due to its atypical clinical manifestations,it has long puzzled clinicians how to clearly diagnose it.Magnetic resonance imaging(MRI)is one of the commonly used means of examination,but studies have found that MRI can only be used as a hint for diagnosis of DLBP and a screening imaging index.Discography is considered the gold standard of diagnosis,but recent studies have shown that the procedure itself may increase the risk of disc degeneration and herniation.The treatment methods of DLBP are also varied,including conservative treatment,surgical treatment and emerging biological therapy,et al.But the effect of most methods is still unclear,and more clinical studies are needed to verify them.This article reviews the latest advances in the pathogenesis,diagnosis and treatment of discogenic low back pain through a retrospective analysis of domestic and foreign literatures in recent years.