アブストラクト
Japanese
| Title | 仙腸関節痛の発生・慢性化のメカニズム |
|---|---|
| Subtitle | 総説 特集1 : 腰痛の発生・慢性化のメカニズム |
| Authors | 黒澤大輔, 村上栄一 |
| Authors (kana) | |
| Organization | JCHO仙台病院日本仙腸関節・腰痛センター |
| Journal | Journal of Spine Research |
| Volume | 12 |
| Number | 6 |
| Page | 808-813 |
| Year/Month | 2021 / |
| Article | 報告 |
| Publisher | 日本脊椎脊髄病学会 |
| Abstract | 「要旨」仙腸関節は脊柱の基部で体幹と下肢の境界に存在し, わずかな関節運動で衝撃吸収装置として機能している. 不意の動きや繰り返しの動作で関節に微小な不適合が生じて仙腸関節障害が発症する. 多くは仙腸関節ブロックによる早期診断と徒手療法を含めた早期治療により解決するが, 慢性・重症化して深刻なQOL 低下をきたすことがある. 難治例は1)外傷性の周囲靭帯・関節包の損傷, 2)仙腸関節腔内の炎症, 3)周囲靭帯付着部症という3 つの病態メカニズムに分類して対応する. 明らかな外傷を契機に発症した仙腸関節障害のうち, 関節腔内へ注入した造影剤が容易に漏出する症例が存在し, 特に若年者では外傷により不可逆的な関節の不適合および周囲靭帯・関節包の損傷が生じたことで, 仙腸関節痛が慢性化している可能性がある. 仙腸関節の微小な不適合が慢性的に持続すると, 関節腔内の炎症を生じることがあり, 同様に, 仙結節靭帯および長後仙腸靭帯などの仙腸関節周囲靭帯に過剰な牽引力がかかり続けることで, 足底腱膜炎と同様の難治性の靭帯付着部症が生じ得る. 重症例に対しては関節腔内ブロック, 体外衝撃波, 仙腸関節固定術を検討する. |
| Practice | 臨床医学：外科系 |
| Keywords | 仙腸関節, 疼痛, 病態, Sacroiliac joint, Pain, Pathomechanism |
English
| Title | Mechanisms of onset and chronicity of sacroiliac joint pain |
|---|---|
| Subtitle | Review Article |
| Authors | Daisuke Kurosawa, Eiichi Murakami |
| Authors (kana) | |
| Organization | The Japan Sacroiliac Joint and Low Back Pain Center, JCHO Sendai Hospital |
| Journal | Journal of Spine Research |
| Volume | 12 |
| Number | 6 |
| Page | 808-813 |
| Year/Month | 2021 / |
| Article | Report |
| Publisher | The Japanese Society for Spine Surgery and Related Research |
| Abstract | [Abstract] The sacroiliac joint (SIJ) functions as a shock absorber with a narrow range of motion at the base of the spine, at the interface between the trunk and lower limbs. SIJ disorders occur due to minor subluxation of the joint caused by unintentional or repetitive movements in activities of daily living. Most cases are resolved by early diagnosis with SIJ injections and early treatment including manual therapies, but chronic and severe cases may lead to a severe deterioration in quality of life. Severe cases are classified into three pathological mechanisms: 1) traumatic damage to the surrounding ligaments and joint capsule; 2) inflammation within the SIJ cavity; and 3) enthesopathy of the periarticular ligamentous bone attachment sites. Among the SIJ disorders caused by obvious traumatic accidents, some patients are susceptible to contrast medium leakage from the joint cavity, particularly young patients who may experience chronic SIJ pain due to irreversible joint maladjustment and damage to the periarticular ligaments and joint capsule caused by trauma. Prolonged subluxation of the joint may result in intraarticular inflammation, and similarly, continued excessive traction on the periarticular ligaments, such as the sacrotuberous and long posterior sacroiliac ligaments, may result in enthesopathy similar to severe plantar tendinitis. Intra-articular SIJ injections, extracorporeal shock wave therapies, and SIJ arthrodesis should be considered in severe cases. |
| Practice | Clinical surgery |
| Keywords | Sacroiliac joint, Pain, Pathomechanism |
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残りの22件を表示する
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