老年腰椎间盘突出症：特点与诊疗思路

Elderly Lumbar Disc Herniation: Characteristics and Diagnosis and Treatment Ideas

摘要: 老年腰椎间盘突出症患者包括60岁以后发病的患者和在早期便诊断为腰椎间盘突出症的老年患者，在患有腰椎间盘突出的病理基础上，病理性突出的椎间盘组织刺激或压迫到相应的马尾神经、神经根，所导致的一系列以腰背部疼痛、下肢放射痛、下肢麻木乏力、大小便功能障碍等为表现的临床综合征，严重影响老年患者生活质量。老年腰椎间盘突出患者往往具有多重用药、全身受累情况更加严重以及疗效差的特点。本文从发病机制、特点、治疗手段等方面对老年腰椎间盘突出症进行了一个简单的梳理，以期制定出为老年腰椎间盘突出症量身定制的临床实践方法，更进一步提高老年腰椎间盘突出症的诊疗效果，对提高老年患者的生活质量具有重大意义。

Abstract: Elderly patients with lumbar disc herniation include patients after 60 years old and elderly pa-tients diagnosed as lumbar disc herniation in the early stage. On the basis of pathology of lumbar disc herniation, pathological protrusion of the intervertebral disc tissue stimulates or compresses to the corresponding caudaequina nerve and nerve root, resulting in a series of clinical syndromes characterized by low back pain, lower limb radiation pain, lower limb numbness and fatigue, and urination dysfunction, which seriously affect the quality of life of elderly patients. Elderly patients with lumbar disc herniation often have multiple medications, more serious systemic involvement and poor efficacy. This paper briefly reviews the pathogenesis, characteristics and treatment of lumbar disc herniation in the elderly, in order to develop a customized clinical practice method for lumbar disc herniation in the elderly, and further improve the diagnosis and treatment effect of lumbar disc herniation in the elderly, which is of great significance to improve the quality of life of elderly patients.