急性腰骶神经根病：预后与治疗
- Authors
- Kerry Levin, MD
Kerry Levin, MD
- Chairman, Department of Neurology
- Cleveland Clinic
- Professor
- Cleveland Clinic Lerner College of Medicine
- Philip S Hsu, MD
Philip S Hsu, MD
- Assistant Professor
- Tufts University School of Medicine
- Carmel Armon, MD, MHS
Carmel Armon, MD, MHS
- Chairman, Department of Neurology
- Assaf Harofeh Medical Center
- Associate Clinical Professor of Neurology
- Tel Aviv University Sackler School of Medicine
- Section Editor
- Jeremy M Shefner, MD, PhD
Jeremy M Shefner, MD, PhD
- Section Editor — Neuromuscular Disease
- Professor and Chair of Neurology, Barrow Neurological Institute
- Professor of Neurology, University of Arizona, Phoenix
- Clinical Professor of Neurology, Creighton University
- Deputy Editor
- John F Dashe, MD, PhD
John F Dashe, MD, PhD
- Deputy Editor — Neurology
- Translators
- 李黔宁, 主任医师，教授
李黔宁, 主任医师，教授
- 第三军医大学新桥医院神经内科
引言
腰骶神经根病是指疾病过程影响到一个或多个腰骶神经根功能的一种疾病。最常见的原因是导致神经根受压的结构性病变(即，椎间盘突出或退行性椎管狭窄)。
本专题将总结腰骶神经根病的预后与治疗，重点是急性期(不超过4周)病变。腰骶神经根病的其他临床内容及腰椎管狭窄的治疗将单独讨论。 (参见“腰骶神经根病：病理生理学、临床特征及诊断”和“腰椎管狭窄症：治疗和预后”)
亚急性和慢性腰痛的治疗参见其他专题。 (参见“亚急性和慢性腰痛的非手术介入治疗”和“亚急性腰痛和慢性腰痛的药物和非介入治疗”和“亚急性和慢性腰痛的手术治疗”)
预后
虽然急性腰骶神经根病通常极其疼痛，但当病因是椎间盘突出或退行性关节炎导致的腰椎管狭窄时，则认为自发缓解可能性较高。然而，关于腰骶神经根病自然病程的数据有限。
随机试验的安慰剂对照组中可获得一些信息。就这点而言，一项纳入208例急性L5和/或S1神经根病患者的试验发现，被分配接受非甾体类抗炎治疗或安慰剂治疗的患者在第4周时的结局差异无统计学意义，并且大多数患者都获得了令人满意的恢复情况[1]。第3个月时，两组中都有30%左右的患者仍报告有腰痛。
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To continue reading this article, you must log in with your personal, hospital, or group practice subscription. For more information or to purchase a personal subscription, click below on the option that best describes you:Literature review current through: 2017-06 . | This topic last updated: 2017-04-24.The content on the UpToDate website is not intended nor recommended as a substitute for medical advice, diagnosis, or treatment. Always seek the advice of your own physician or other qualified health care professional regarding any medical questions or conditions. The use of this website is governed by the UpToDate Terms of Use ©2017 UpToDate, Inc.References- Weber H, Holme I, Amlie E. The natural course of acute sciatica with nerve root symptoms in a double-blind placebo-controlled trial evaluating the effect of piroxicam. Spine (Phila Pa 1976) 1993; 18:1433.
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