非创伤性股骨头坏死发病机制及腰交感神经 射频治疗的展望

Pathogenesis of Non-Traumatic Osteonecrosis Necrosis of the Femoral Head and Prospects of Radiofrequency Treatment of Lumbar Sympathetic Nerve

摘要: 股骨头缺血性坏死(ONFH)是一种股骨近端血供中断或血供不足引起的，其主要表现为骨组织及骨髓成分死亡，进而导致股骨头塌陷和关节功能障碍等临床症状。L2、3交感神经处于兴奋状态时，会引起股骨头区域的血管收缩，从而减少股骨头血供。当较高神经被抑制时，血管会扩张，血流增加。然而，非创伤性股骨头缺血性坏死的发病机制尚不明确，其中以激素性股骨头坏死(SANFH)较为常见。本文简要回顾了SANFH的发病机制及L2、3交感神经在股骨头坏死治疗中的作用，以增强对SANFH发病机制、预防及早期干预的认识。

Abstract: Osteonecrosis necrosis of the femoral head (ONFH) is a condition caused by interruption or insufficiency of blood supply to proximal femur, primarily characterized by the death of bone tissue and bone marrow components, leading to clinical symptoms such as femoral head collapse and joint dysfunction. When the L2, 3 sympathetic nerves are in an excited state, they induce vasoconstriction in the femoral head region, thereby reducing blood supply to the femoral head. When these nerves are inhabited, vasodilation occurs, increasing blood flow. However, the pathogenesis of non-traumatic ONFH remains unclear, with steroid-associated necrosis of the femoral head (SANFH) being the most common form. This article briefly reviews the pathogenesis of SANFH and the role of the L2, 3 sympathetic nerves in the treatment of femoral head necrosis, aiming to enhance the understanding of the pathogenesis, prevention, and early intervention of SANFH.