退行性腰椎不稳发病相关的结构因素及治疗研究进展

Progress of anatomy changes and treatment of degenerative lumbar instability

腰椎不稳定(lumbar instability)被认为是发生下腰部疼痛的常见原因[1],现在对于腰椎不稳的定义及诊断尚未形成统一意见,目前主要以患者的症状及体格检查结合影像学资料作为诊断腰椎不稳的依据。常用腰椎动力位X线片作为诊断腰椎不稳的方法,虽然未形成统一的标准来诊断腰椎不稳,多数医生采用动力位X线片,以腰椎体滑移>3 mm,或成角>15°为腰椎节段不稳作为诊断依据。朱勇等[2]对腰椎不稳的定义进行了总结,将腰椎不稳定义为生理负荷下腰椎失去控制异常活动的能力,腰椎处于失代偿下的非平衡状态,并会进一步导致神经刺激或神经损伤症状的疾病。

Degenerative lumbar instability is common,which may induce lower back pain,but its mechanism is not clear.Most studies consider age,degenerated intervertebral disc and small facet osteoarthritis are risk factors,and anatomy components of the spine interact with each other in the degeneration process.Study on anatomy changes may help to increase the understanding of lumbar instability and guide the treatment.