臨床整形外科57巻11号

2022年11月発行

特集 腰椎椎間板ヘルニアのCutting Edge

腰椎椎間板ヘルニアに対する治療の実際

著者： 井上玄¹

所属機関： ¹北里大学医学部整形外科学

ページ範囲：P.1325 - P.1329

腰椎椎間板ヘルニアは日常診療で最も診療する機会が多い疾患の1つである．膀胱直腸障害や著明な筋力低下など，術後の回復が思わしくない病態を除き，自然経過でのヘルニア吸収が期待できるため，少なくとも2，3カ月の保存療法が望ましいとされる．代表的な保存療法である薬物療法，神経ブロック，理学療法を，患者個々に適して選択することが重要である．手術療法に関しては，現状で長期的にはコンセンサスは得られていないが，少なくとも短期間での有効性は確立されている．今後，低侵襲術式や髄核融解療法などの新たな治療の発展とともに治療体系も変化していくものと考えられる．

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