スポーツ選手の腰痛と低侵襲手術 : 謎の腰痛を解き明かす

Low back pain is commonly occurred among athletes. There are some pathologies causing the pain, and most of the pathology would be based on the overuse of the spine during the sports performance. Thus, the clue to obtain the exact diagnosis of the back pain is the lumbar motion causing the pain. Roughly, the pathology is classified into two ; i.e., flexion pain and extension pain. In flexion, anterior component of the spine such as intervertebral disc and endplate is loaded. Thus, disorders causing flexion pain would be disc herniation, discogenic pain, type １ Modic endplate inflammation and so on. During the lumbar extension motion, posterior element including the facet joints and lamina is loaded. Based on this phenomenon, the lumbar spondylolysis and facet joint arthritis would be the main pathology causing the extension pain. Once the exact diagnosis can be obtained, pin-point intervention is possible including the block therapy and endoscopic surgery. The state of the art minimally invasive disc surgery is the endoscopic surgery. The technique is called the percutaneous endoscopic discectomy （PED）. It only requires ８ mm for the skin incision, and it can be done under the local anesthesia. With utilizing the PED system, we have been treating the athletes with disc herniation and discogenic pain minimally invasively.