Abstract：
UNASSIGNED: The interspinous region is an atypical source of low back pain, and it can often be difficult to identify. There are many structural components in the interspinous region that can contribute to interspinous pain, including the interspinous ligament, which plays a role in providing stabilization to the spine. Successful treatments of interspinous pain have not been well characterized in the literature. This case presents the first documentation of the use of extracorporeal shockwave therapy as a noninvasive treatment for refractory interspinous-related low back pain. Extracorporeal shockwave therapy has previously been shown to facilitate regeneration and tissue healing in tendons and ligaments but has not previously been used to treat interspinous pain. A 24-yr-old former collegiate softball player presented with 5 mos of low back pain; the interspinous ligament was clinically suspected as a pain generator, and this was confirmed via an ultrasound-guided injection. She underwent a course of physical therapy that improved function but did not improve pain, and nonsteroidal anti-inflammatory drugs only provided minimal and temporary relief. Three consecutive extracorporeal shockwave therapy treatment sessions provided 90% improvement in pain and function, and she was able to return to exercise and recreational sports. At more than 6 mos after extracorporeal shockwave therapy treatment, she reported no recurrences or functional limitations.
摘要：
■棘突间区域是下腰痛（LBP）的非典型来源，通常很难识别。棘突间区域有许多结构成分可导致棘突间疼痛，包括棘间韧带（ISL），在提供脊柱的稳定作用。在文献中还没有很好地描述棘突间疼痛的成功治疗。该病例介绍了使用体外冲击波疗法（ESWT）作为难治性棘突间相关LBP的非侵入性治疗的第一份文献。ESWT先前已被证明可以促进肌腱和韧带的再生和组织愈合，但以前从未用于治疗棘突间疼痛。一名24岁的前大学垒球运动员接受了5个月的LBP治疗；ISL在临床上被怀疑是疼痛发生器，这是通过超声引导注射证实的。她接受了一个疗程的物理治疗，改善了功能，但没有改善疼痛，和非甾体抗炎药仅提供最小和暂时的缓解。连续三次ESWT治疗可使疼痛和功能改善90％，她能够恢复锻炼和娱乐运动。在ESWT治疗后>6个月，她报告没有复发或功能限制。
