BMJ Best Practice
最后审核时间： 十月 2018
最近更新时间： 一月 2018

小结

定义

病史和查体

关键诊断因素

  • 肥胖、应激和精神共病
  • 下腰痛发作史
  • 下腰痛既往治疗史
  • 病史时间<12周
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其他诊断因素

  • 与肌肉痉挛相关的钝痛、咬痛、撕裂痛、烧灼痛或电击痛
  • 屈曲位疼痛不明显或伸展位疼痛减轻
  • 脊柱侧弯或驼背
  • FABER试验、Gaenslen试验或Schober试验阴性
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危险因素

  • 肥胖
  • 退行性椎间盘病变家族史
  • 社会压力和精神共病
  • 年龄增长，最高至60-65岁
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诊断性检查

首要检查

  • 临床诊断
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需要考虑的检查

  • 腰椎X光片
  • 腰椎核磁
  • 腰椎CT
  • 脊髓造影
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治疗流程

急性

急性下腰痛：<4周

疾病持续状态

亚急性下腰痛：4-12周

慢性下腰痛：>12周

复发性下腰痛

贡献者

作者 查看所有

Interim Chairman and Professor

Department of Physical Medicine and Rehabilitation

University of Miami Miller School of Medicine

Miami

FL

利益冲突披露
RWI declares that he has no competing interests.

Professor and Vice Chair

Department of Physical Medicine & Rehabilitation

University of Miami Miller School of Medicine

Miami

FL

利益冲突披露
AS declares that he has no competing interests.

Dr Robert Irwin and Dr Andrew Sherman would like to gratefully acknowledge Dr Louise Thwaites, Dr Karen Walker-Bone, Dr Joanne Borg-Stein, and Dr Philip Chiou, the previous contributors to this monograph. LT, KWB, JBS, and PC declare that they have no competing interests.

同行评议专家 查看所有

Staff Physiatrist

Orthopedic and Arthritis Center

Brigham and Women's Hospital

Chestnut Hill

MA

利益冲突披露
JB declares that she has no competing interests.

Interventional Spine Physiatrist

Pain Medicine Specialist

Medical Director

Spine Center

Lahey Clinic

Burlington

MA

利益冲突披露
AGC declares that he has no competing interests.

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