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Isjias, prolaps i korsryggen

Prolaps (isjias) skyldes at en mellomvirvelskive i ryggen sprekker og innholdet i skiven tyter ut og presser på en nerve. Det gir utstrålende smerter nedover i beinet.

Ved prolaps (isjas) i ryggen gir man i starten vanligvis ingen aktiv behandling, men avventer og ser hvordan tilstanden utvikler seg.

Sist oppdatert:

5. juli 2023

Vil du vite mer

Dette dokumentet er basert på det profesjonelle dokumentet Lumbale rotaffeksjoner . Referanselisten for dette dokumentet vises nedenfor

  1. Hsu PS, Armon C, Levin K. Acute lumbosacral radiculopathy: Pathophysiology, clinical features, and diagnosis. UpToDate, last updated Aug 27, 2021. UpToDate
  2. Ihlebæk C, Brage S, Natvig B, Bruusgaard D. Forekomst av muskel- og skjelettlidelser i Norge. Tidsskr Nor Legeforen 2010; 130: 2365-8 . doi:10.4045/tidsskr.09.0802 DOI
  3. Mistry J, Heneghan NR, Noblet T, Falla D, Rushton A. Diagnostic utility of patient history, clinical examination and screening tool data to identify neuropathic pain in low back related leg pain: a systematic review and narrative synthesis. BMC Musculoskelet Disord. 2020;21(1):532. Published 2020 Aug 10. PMID: 32778086 PubMed
  4. Barraclough K. Cauda equina syndrome. BMJ. 2021;372:n32. Published 2021 Jan 12. PMID: 33436390 PubMed
  5. Mygland Å. Isjias og cauda equina syndromet. NEL Nevrologi. Sist revidert 31.10.2017. Siden besøkt 17.12.2020. nevrologi.legehandboka.no
  6. Al Nezari NH, Schneiders AG, Hendrick PA. Neurological examination of the peripheral nervous system to diagnose lumbar spinal disc herniation with suspected radiculopathy: a systematic review and meta-analysis. Spine J 2013 Jun;13(6):657-74. doi: 10.1016/j.spinee.2013.02.007. DOI
  7. Nasjonal faglig retningslinje for bildediagnostikk ved ikke-traumatiske muskel- og skjelettlidelser. Anbefalinger for primærhelsetjenesten. Oslo, Helsedirektoratet 2014. www.helsedirektoratet.no
  8. el Barzouhi A, Vleggeert-Lankamp CL, Lycklama a Nijeholt GJ, et al. Magnetic resonance imaging in follow-up assessment of sciatica. N Engl J Med 2013 Mar 14;368(11):999-1007. doi: 10.1056/NEJMoa1209250. DOI
  9. Magnæs B. Kirurgisk behandling ved lidelser i korsryggen. Tidsskr Nor Lægeforen 1999; 119: 1773-7. PubMed
  10. Schoenfeld AJ, Weiner BK. Treatment of lumbar disc herniation: evidence-based practice. Int J Gen Med 2010;3:209-214. PubMed
  11. Clark R, Weber RP, Kahwati L. Surgical Management of Lumbar Radiculopathy: a Systematic Review. J Gen Intern Med 2019. s11606-019-05476-8. pmid:31713029 PubMed
  12. Liu C, Gerreira GE, Shaheed CA, et al. Surgical versus non-surgical treatment for sciatica: systematic review and meta-analysis of randomised controlled trials. BMJ 2023; 381: e070730. pmid:37076169 PubMed
  13. Bailey CS, Rasoulinejad P, Taylor D, et al. Surgery versus Conservative Care for Persistent Sciatica Lasting 4 to 12 Months. N Engl J Med 2020; 382:1093-1102. www.nejm.org
  14. Schoenfeld AJ, Kang JD. Decision Making for Treatment of Persistent Sciatica. N Engl J Med 2020; 382:1161-1162. www.nejm.org
  15. Bailey C, Glennie A, Rasoulinejad P, et al. Discectomy Compared with Standardized Nonoperative Care for Chronic Sciatica Due to a Lumbar Disc Herniation A Secondary Analysis of a Randomized Controlled Trial with 2-Year Follow-up. J Bone Joint Surg Am 2021.
  16. Suri P, Hunter DJ, Jouve C, et al. Nonsurgical treatment of lumbar disk herniation: are outcomes different in older adults. J Am Geriatr Soc 2011; 59: 423-9. PubMed
  17. Valat JP, Genevay S, Marty M, Rozenberg S, Koes B. Sciatica. Best Pract Res Clin Rheumatol. 2010;24(2):241-252. PubMed
  18. Dahm KT, Brurberg KG, Jamtvedt G, Hagen KB. Advice to rest in bed versus advice to stay active for acute low-back pain and sciatica. Cochrane Database of Systematic Reviews 2010, Issue 6. Art. No.: CD007612. DOI: 10.1002/14651858.CD007612.pub2. DOI
  19. Lewis RA, Williams NH, Sutton AJ et al. Comparative clinical effectiveness of management strategies for sciatica: systematic review and network meta-analyses. Spine J 2015; 15(6): 1461-77. pmid:24412033 PubMed
  20. Rasmussen-Barr E, Held U, Grooten WJ, et al. Non-steroidal anti-inflammatory drugs for sciatica. Cochrane Database Syst Rev. 2016 Oct 15;10:CD012382. Epub ahead of print. pmid: 27743405 PubMed
  21. Goldberg H, Firtch W, Tyburski M, et al. Oral steroids for acute radiculopathy due to a herniated lumbar disk. A randomized clinical trial. JAMA 2015; 313: 1915-23. doi:10.1001/jama.2015.4468 DOI
  22. Mathieson S, Maher CG, McLachlan AJ, et al. Trial of pregabalin for acute and chronic sciatica. N Engl J Med 2017 Mar 23; 376:1111. PMID: 28328324 PubMed
  23. Iversen T, Solberg TK, Rommner B, et al. Effect of caudal epidural steroid or saline injection in chronic lumbar radiculopathy; multicentre, blinded, randomised controlled trial. BMJ 2011; 343: d5278. BMJ (DOI)
  24. Chou R, Hashimoto R, Friedly J, et al. Epidural corticosteroid injections for radiculopathy and spinal stenosis: A systematic review. Ann Intern Med 2015. doi:10.7326/M15-0934 DOI
  25. Bhatia A, Flamer D, Shah PS. Perineural steroids for trauma and compression-related peripheral neuropathic pain: a systematic review and meta-analysis. Can J Anaesth. 2015. pmid:25744141 PubMed
  26. Peul WC, van Houwelingen HC, van den Hout WB, et al, for the Leiden-The Hague Spine Intervention Prognostic Study Group. Surgery versus prolonged conservative treatment for sciatica. N Engl J Med 2007; 356: 2245-56. New England Journal of Medicine
  27. Gibson JNA, Waddell G. Surgical interventions for lumbar disc prolapse. Cochrane Database Syst Rev, issue 2, 2007. The Cochrane Library
  28. Peul WC, van Houwelingen HC, van den Hout WB, et al. Surgery versus prolonged conservative treatment for sciatica. N Engl J Med. 2007;356(22):2245-2256. PubMed
  29. Pearson A, Blood E, Frymoyer J, Herkowitz H, Abdu W, Woodward R, et al. SPORT intervertebral disc herniation: does back pain improve with surgery? In: Proceedings of 34th meeting of the International Society for the Study of the Lumbar Spine, Hong Kong, 10-14 June 2007:13. www.issls.org.
  30. Bailey CS, Rasoulinejad P, Taylor D, et al. Surgery versus Conservative Care for Persistent Sciatica Lasting 4 to 12 Months. N Engl J Med. 2020;382(12):1093-1102. PubMed
  31. Ahlburg P, Duel P, Spangsberg NLH, Albeck MJ. Operation for lumbal diskusprolaps uden hospitalsindlæggelse. Ugeskr Læger 2005; 167: 1852-5. PubMed
  32. Oosterhuis T, Costa LO, Maher CG, et al. Rehabilitation after lumbar disc surgery. Cochrane Database Syst Rev. 2014 Mar 14;3:CD003007. PMID: 24627325. PubMed
  33. Wegner I, Widyahening IS, van Tulder MW, et al. Traction for low-back pain with or without sciatica. Cochrane Database Syst Rev 2013; 8: CD003010. doi:23959683 The Cochrane Library
  34. Kreiner DS, Hwang SW, Easa JE, et al. An evidence-based clinical guideline for the diagnosis and treatment of lumbar disc herniation with radiculopathy. Spine J 2014; 14:180. PubMed
  35. Valen B, Rolfsen L. Kvalitetssikring av ryggkirurgi. Oppfølging av 350 isjiasopererte pasientar etter 2-16 år ved bruk av overlevingsanalyse. Tidsskr Nor Lægeforen 1998; 118: 2136-9. PubMed
  36. Graver V, Haaland AK, Loeb M, Magnæs B. 7-year follow-up after lumbar disc surgery. Results and predictors of outcome. Br J Neurosurg 1999; (in press).
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