中新网上海8月2日电 (陈静 何佳楠)上海冬雷脑科医院脊柱外科专家温超轮2日接受记者采访时表示，腰椎间盘突出的一个主要原因是民众年龄增长导致的腰椎间盘退行性改变。中老年人群发生椎间盘突出症的概率明显高于青壮年人群。
温超轮解释，髓核是乳白色半透明胶状体，组织中70%以上是水分，具有很好的弹性。在运动中，椎间盘起到减震、连接以及保证腰椎活动度的作用。但随着人的年龄增加，椎间盘髓核中所含的水分逐渐减少，受损伤后自身修复能力逐渐下降。
温超轮强调，腰椎是连接胸廓和骨盆的骨性结构，是脊柱中负重最大的部位。脊柱状态好坏，直接关系身体健康和生活质量。长时间坐姿不正确，或长时间保持同一姿势；缺乏运动，导致腰部肌肉力量不足；过度劳累，使椎间盘承受过大的压力；急性损伤以及遗传因素等也是不可忽视的诱因。
温超轮指出，如何区分腰椎间盘突出症和腰肌劳损？腰椎间盘突出的典型症状包括腰痛、下肢疼痛、麻木以及肌肉萎缩等。与腰肌劳损相比，腰椎间盘突出的症状更为严重，疼痛更为剧烈且常伴有下肢麻木等症状。
温超轮建议，对于腰椎间盘突出的检查，磁共振和X光是两种常用的方法。两者结合使用，可以大大提高诊断的准确性。磁共振主要用于观察椎间盘和神经情况，X光则侧重于骨头的检查。
温超轮表示，如何治疗腰椎间盘突出？药物治疗和手术治疗是两种主要手段。药物治疗包括止痛药、消炎药等，适用于症状较轻的患者。而手术治疗则通常在病情严重且无法通过药物和其他非手术方法缓解时进行，如微创手术和开放手术等。
温超轮分享了一个病例，56岁的黄女士长期从事体力劳动。自2023年起，她频繁出现腰痛。起初，她并没有太在意。2024年以来，黄女士的病症已严重影响其日常行走及夜间休息。根据腰椎磁共振检查结果，温超轮诊断她罹患腰椎间盘突出症。这位专家表示，黄女士的腰椎间盘突出症状已经很严重，常规治疗已经无法解决问题，需要手术。
脊柱外科团队为黄女士实施了微创手术——椎间孔镜下的腰椎间盘摘除术。手术在局部麻醉下进行，切口微小，不足1厘米。术后当天，黄女士的疼痛感明显减轻，术后恢复良好。温超轮提醒，预防腰椎间盘突出症，应注重合理运动、保持正确坐姿、定期进行腰部肌肉锻炼，以及避免长时间保持同一姿势。
英语如下：
Title: “Older Adults Beware: High Incidence of Lumbar Disc Herniation”
Keywords: Degenerative, Middle-aged and Elderly, Lumbar Disc Herniation
Content:
SHANGHAI, Aug. 2 (Xinhua) — Dr. Wen Chao-lun, a spine surgery expert at Shanghai Winter Thunder Brain Hospital, told reporters on Tuesday that the primary cause of lumbar disc herniation is the degenerative change of the intervertebral discs due to aging. The probability of developing intervertebral disc herniation is significantly higher in the middle-aged and elderly population compared to young adults.
Dr. Wen explained that the nucleus pulposus is a semi-transparent, gelatinous substance that is milky white in color, containing over 70 percent water and possessing excellent elasticity. It plays a role in shock absorption, connection, and ensuring the range of motion of the lumbar spine during movement. However, as people age, the water content in the intervertebral disc’s nucleus pulposus gradually decreases, and the ability to repair damage diminishes.
Dr. Wen emphasized that the lumbar spine serves as the bony structure connecting the thorax and pelvis, and it is the most heavily loaded area in the spine. The health of the spine directly affects overall health and quality of life. Long periods of incorrect sitting posture or maintaining the same posture for a long time; lack of exercise leading to insufficient muscle strength in the waist; excessive strain; acute injuries; and genetic factors are also significant contributing factors.
Dr. Wen pointed out that how can you distinguish between lumbar disc herniation and muscle strain of the waist? The typical symptoms of lumbar disc herniation include lower back pain, leg pain, numbness, and muscle atrophy. Compared to muscle strain of the waist, the symptoms of lumbar disc herniation are more severe, with more intense pain and often accompanied by symptoms such as numbness in the legs.
Dr. Wen recommended that for the diagnosis of lumbar disc herniation, magnetic resonance imaging (MRI) and X-rays are two commonly used methods. The combination of the two can significantly improve the accuracy of the diagnosis. MRI is mainly used to observe the condition of the intervertebral discs and nerves, while X-rays focus on checking the bones.
Dr. Wen stated that how is lumbar disc herniation treated? Drug therapy and surgical intervention are the two primary approaches. Drug therapy includes painkillers and anti-inflammatory drugs and is suitable for patients with mild symptoms. Surgical treatment, on the other hand, is usually performed when the condition is severe and cannot be alleviated through medication and other non-surgical methods, such as minimally invasive surgery and open surgery.
Dr. Wen shared a case of a 56-year-old woman surnamed Huang, who has been engaged in physical labor for a long time. Since the beginning of 2023, she has frequently experienced back pain. Initially, she did not take it seriously. However, since 2024, her condition has significantly affected her daily walking and nighttime rest. Based on the results of a lumbar MRI, Dr. Wen diagnosed her with lumbar disc herniation. This expert stated that the lumbar disc herniation symptoms of Ms. Huang were already severe, and conventional treatment could no longer solve the problem, requiring surgery.
The spine surgery team performed a minimally invasive surgery on Ms. Huang – a discectomy under the microscope of the lumbar disc. The operation was conducted under local anesthesia, with a small incision of less than 1 centimeter. On the day after the operation, Ms. Huang’s pain significantly reduced, and her recovery was good. Dr. Wen reminded that to prevent lumbar disc herniation, it is important to engage in reasonable exercise, maintain a correct sitting posture, regularly exercise the waist muscles, and avoid maintaining the same posture for a long time.
【来源】http://www.chinanews.com/life/2024/08-02/10262436.shtml
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