腰痛治療の最前線

It has been reported that more than 80% of the entire population in Japan would have low
back pain in their life at least once. However, the cause of the pain is different among ages. In children and adolescents, the lumbar spondylolysis is the most popular disease, and the apophyseal bony ring fracture is the specific disease which would be only seen in such young generation. For each disease, prevention is important. Tightness of the hamstrings is closely related to the low back pain. We proposed the effective active stretching exercise called “Jack-knife stretching” for young generation, so that they can be flexible soon, and prevent the low back pain. For adults, herniated nucleus pulposus （HNP） and spinal canal stenosis would be popular. To treat these diseases, endoscopic surgery is the state-of-the-art technique. Especially for HNP, percutaneous endoscopy was introduced with local anesthesia. The technique made the disc surgery possible to be “one-day surgery” because of its minimal invasiveness. For the elderly people, compression fracture based on the fragile spine with osteoporosis is popular. Recently, very effective drugs to increase the bone mineral density have been utilized. For the compression fracture, less invasive technique to reduce the low back pain by the fracture is induced called “balloon kyphoplasty”. In this review article, the state-of-the-art of the low back pain was presented.