脊柱小关节骨关节炎诊治专家共识  

Expert consensus on clinical diagnosis and treatment of facet joint osteoarthritis

作　　者：李锋[1] 宋跃明[2] 方忠[1] 李毅中[3] 熊伟[1] 马真胜 周晓岗 徐华梓[6] 钱济先 刘文革[8] 孙宇[9] 孙嗣国 杨惠林[10] 杨操[11] 罗卓荆 高延征[12] 梁伟 黄霖[13] 曾建成[2] 沈慧勇[13] 郑召民[14] 林建华[15] 蒋电明 戴闽[17] LI Feng;SONG Yue-ming;FANG Zhong;LI Yi-zhong;XIONG Wei;MA Zhen-sheng;ZHOU Xiao-gang;XU Hua-zi;QIAN Ji-xian;LIU Wen-ge;SUN Yu;SUN Si-guo;YANG Hui-lin;YANG Cao;LUO Zhuo-jing;GAO Yan-zheng;LIANG Wei;HUANG Lin;ZENG Jian-cheng;SHEN Hui-yong;ZHENG Zhao-min;LIN Jian-hua;JIANG Dian-ming;DAI Min(Orthopaedics Department,Tongji Hospital,Tongji Medical（College,Huazhong University of Science and Technology,Wuhan 430030;Orthopaedics Department,West China;Hospital,Sichuan University,Chengdu 61004;3Orthopaedics Department,the Second Affiliated Hospital of Fujian Medical University,Quanzhou 36200;4Orthopaedics Department,Xijing Hospital,Air Force Military Medical University,Xi--an 71003;5Orthopaedics Department,Zhongshan Hospital,Fudan University,Shanghai 20003;6Orthopaedics Department,the Second Affiliated Hospital of Wenzhou Medical University,Wenzhou 325027;7Orthopaedics Department,Tangdu Hospital,Air Force Military Medical University,Xi--an,710038;8Orthopaedics Department,Union Hospital,Fujian Medical University,Fuzhou 35000;Orthopaedic;epartment,Peking University Third Hospital,Beijing 10019;0Orthopaedics Department,the First Affiliated Hospital of Soochow University,Suzhou 21500;1Orthopaedic Department,Union Hospital,Tongji Medical College,Huazhong Science and Technology University,Wuhan 43002;2Orthopaedics Department,People--＇;ospital of Henan Province,Zhengzhou 45000;3Orthopaedics Department,Sun Yat-sen Memorial Hospital,Sun Yat-sen University,Guangzhou 51012;4Orthopaedics Department,the First Affiliated Hospital of Sun Yat-sen University,Guangzhou 51008;5Orthopaedics Department,First Affiliated Hospital of Fujian Medical University,Fuzhou 35000;6Orthopaedics Department,the Third Affiliated Hospital of Chongqing Medical University,Chongqing,40001;7Orthopaedics Department,the First Affiliated Hospital of Nanchang University,Nanchang330000,China)

机构地区：[1]华中科技大学同济医学院附属同济医院骨科,武汉430030 [2]四川大学华西医院骨科,成都610041 [3]福建医科大学附属第二医院骨科,福建泉州362000 [4]空军军医大学西京医院骨科,西安710032 [5]复旦大学附属中山医院骨科,上海200032 [6]温州医科大学附属第二医院骨科,浙江温州325027 [7]空军军医大学唐都医院骨科,西安710038 [8]福建医科大学附属协和医院骨科,福州350001 [9]北京大学第三医院骨科,北京100191 [10]苏州大学附属第一医院骨科,江苏苏州215000 [11]华中科技大学同济医学院附属协和医院骨科,武汉430022 [12]河南省人民医院骨科,郑州450003 [13]中山大学孙逸仙纪念医院骨科,广州510120 [14]中山大学附属第一医院骨科,广州510080 [15]福建医科大学附属第一医院骨科,福州350005 [16]重庆医科大学附属第三医院骨科,重庆400016 [17]南昌大学第一附属医院骨科,南昌330000

出　　处：《骨科》2018年第6期417-422,共6页ORTHOPAEDICS

摘　　要：骨关节炎的流行病学、基础和临床研究更多集中在四肢关节,脊柱疾病方面往往更关注的是椎间盘退变及相关神经损伤。临床工作中许多医生对脊柱小关节骨关节炎缺乏足够的认识和关注,从而导致部分脊柱小关节骨关节炎患者被误诊误治。通过查阅文献,遵循循证医学原则,经过全国专家组反复讨论,我们对脊柱小关节骨关节炎诊断和治疗问题达成共识,供广大医师在临床工作中参考应用。脊柱小关节骨关节炎的诊断需结合患者的病史、症状、体征和影像学检查,必要时进行选择性阻滞术,还需要和多种脊柱疾患相鉴别。治疗手段包括基础治疗、药物治疗、介入治疗和手术治疗。在临床工作中,广大医生需对脊柱小关节骨关节炎加强重视、进行正确诊断和有效治疗。Previous epidemiological, basic and clinical researches of osteoarthritis have focused more on limb joints, in addition researches of spinal diseases tend to focus more on disc degeneration and related nerve injuries. Therefore, the lack of knowledge on facet joint osteoarthritis have led to many misdiagnoses and mistreatments of patients. Following the principle of evidence-based medicine, after literature review and repeated discussions among the national expert group, we have reached a consensus on the clinical diagnosis and treatment of facet joint osteoarthritis that can be applied on daily clinical management. The diagnosis of facet joint osteoarthritis requires a combination of medical history, symptoms, physical signs, imaging examinations and selective blocking if necessary. It also requires differential diagnosis with a variety of spinal disorders. Treatment includes basic therapy, drug therapy, interventional therapy and surgical treatment. In clinical work, doctors need to pay more attention to the facet joint osteoarthritis and perform patients correct diagnosis and effective treatment.

关 键 词：脊柱小关节 骨关节炎 诊断 治疗 

分 类 号：R684.3[医药卫生—骨科学]