Hérnia lombar e dor crônica persistente: uma revisão da literatura sobre tratamentos, fatores prognósticos e mecanismos imunoneurológicos
DOI:
https://doi.org/10.34119/bjhrv8n3-107Keywords:
hérnia lombar, dor crônica, imunoneurologiaAbstract
A hérnia de disco lombar é uma condição musculoesquelética prevalente, frequentemente associada à dor lombar e ciática. Apesar dos avanços nas abordagens terapêuticas, muitos pacientes evoluem com dor crônica persistente, especialmente após intervenção cirúrgica.Trata-se de uma revisão da literatura com foco nos tratamentos disponíveis para hérnia lombar, fatores prognósticos relacionados à dor crônica pós-cirúrgica e os mecanismos imunoneurológicos envolvidos. Foram analisados estudos clínicos, revisões sistemáticas e pesquisas experimentais recentes. A dor crônica pós-discectomia afeta até 40% dos pacientes, sendo influenciada por fatores anatômicos, genéticos, neuroimunes e psicossociais. Evidências indicam o papel da micróglia, da fibrose epidural e da atrofia muscular paravertebral na cronificação da dor. Técnicas minimamente invasivas, neuromodulação e programas de reabilitação intensiva têm mostrado eficácia em casos refratários.A dor lombar crônica pós-hérnia discal exige abordagem multidisciplinar e individualizada. A compreensão dos mecanismos imunoneurológicos e a integração entre cirurgia, reabilitação e terapias intervencionistas são fundamentais para melhores resultados clínicos e funcionalidade.
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