腰椎间盘突出重吸收机制在临床康复中的应用OA

Lumbar disc herniation(LDH)is a leading cause of low back pain and radiating pain in the lower extremities.Spon-taneous resorption following non-surgical management has been increasingly observed in some LDH patients.This process involves the partial or complete regression of the herniated disc,resulting in reduced compression on adjacent nerve roots and subsequent alle-viation of clinical symptoms.This review systematically explores the multifactorial determinants influencing the resorption of LDH.These include individual factors such as age and gender,pathological characteristics such as the size and degree of herniation,and external factors including treatment modalities,the presence of Modic changes,lumbar sagittal balance parameters,and specific con-servative interventions.Furthermore,we elucidate the underlying biological mechanisms that drive resorption,which include immune responses,neovascularization,inflammatory reactions,dysregulation of matrix synthesis and catabolism,tissue dehydration,apopto-sis,autophagy,and the tensile role of the posterior longitudinal ligament.Based on these insights,targeted rehabilitation strategies are proposed to promote disc resorption.These approaches focus on restoring the physiological spinal curvature,strengthening the posterior longitudinal ligament,improving local disc microcirculation,facilitating inflammatory metabolism,and alleviating edema.While the current understanding of the precise mechanisms and regulatory pathways of LDH resorption remains incomplete,future research should prioritize elucidating these mechanisms,developing predictive models for resorption potential,and identifying effec-tive therapies to promote resorption.Large-scale,multicenter clinical trials are warranted to establish evidence-based guidelines that optimize conservative treatment outcomes for patients with LDH.