中国组织工程研究

中国组织工程研究 ›› 2026, Vol. 30 ›› Issue (35): 9135-9142.doi: 10.12307/2026.431

• 骨组织构建 bone tissue construction • 上一篇    下一篇

腰椎间盘突出自发性吸收的机制与精准治疗新策略

艾克热木江·木合热木1，2，艾克拜尔江·艾赛提1，2，阿力木江·阿不都肉苏力1，2，库提鲁克·守克尔1，2，沙拉依丁·艾尔西丁1，2，
阿布都吾普尔·太来提3，阿不都乃比·艾力1，2，贾治伟4
  

  1. 1新疆医科大学第六附属医院骨科实验中心，新疆维吾尔自治区乌鲁木齐市   830002；2新疆医科大学骨科再生医学重点实验室，新疆维吾尔自治区乌鲁木齐市   830002；3乌鲁木齐市友谊医院骨一科，新疆维吾尔自治区乌鲁木齐市   830001；4北京中医药大学东直门医院骨伤科，北京市   100701
  • 收稿日期:2025-09-04 修回日期:2026-01-09 出版日期:2026-12-18 发布日期:2026-04-25
  • 通讯作者: 贾治伟，博士，副主任医师，北京中医药大学东直门医院骨伤科，北京市 100701 共同通讯作者：阿不都乃比·艾力，博士，主任医师，新疆医科大学第六附属医院骨科实验中心，新疆维吾尔自治区乌鲁木齐市 830002；新疆医科大学骨科再生医学重点实验室，新疆维吾尔自治区乌鲁木齐市 830002
  • 作者简介:第一作者：艾克热木江·木合热木，男，1985年生，维吾尔族，博士，主任医师，硕士生导师，主要从事骨科再生医学相关研究。 共同第一作者：艾克拜尔江·艾赛提，男，1999年生，维吾尔族，在读硕士，主要从事骨再生、软骨再生、周围神经损伤相关的研究。

Mechanism of spontaneous resorption in lumbar disc herniation and new strategies for precision treatment

Aikeremujiang·Muheremu1, 2, Aikebaierjiang·Aisaiti1, 2, Alimujiang·Abudurousuli1, 2, Kutiluke·Shoukeer1, 2, Sala Yiding·Aierxiding1, 2, Abuduwupuer·Tailaiti3, Abudunaibi·Aili1, 2, Jia Zhiwei4    

  1. 1Orthopedic Experimental Center, The Sixth Affiliated Hospital of Xinjiang Medical University, Urumqi 830002, Xinjiang Uygur Autonomous Region, China; 2Key Laboratory of Regenerative Medicine for Orthopedics, Xinjiang Medical University, Urumqi 830002, Xinjiang Uygur Autonomous Region, China; 3Department of Orthopedics, Urumqi Friendship Hospital, Urumqi 830001, Xinjiang Uygur Autonomous Region, China; 4Department of Orthopedics and Traumatology, Dongzhimen Hospital Affiliated to Beijing University of Chinese Medicine, Beijing 100701, China
  • Received:2025-09-04 Revised:2026-01-09 Online:2026-12-18 Published:2026-04-25
  • Contact: Jia Zhiwei, PhD, Associate chief physician, Department of Orthopedics and Traumatology, Dongzhimen Hospital Affiliated to Beijing University of Chinese Medicine, Beijing 100701, China
  • About author:Aikeremujiang·Muheremu, PhD, Chief physician, Master’s supervisor, Orthopedic Experimental Center, The Sixth Affiliated Hospital of Xinjiang Medical University, Urumqi 830002, Xinjiang Uygur Autonomous Region, China; Key Laboratory of Regenerative Medicine for Orthopedics, Xinjiang Medical University, Urumqi 830002, Xinjiang Uygur Autonomous Region, China Aikebaierjiang·Aisaiti, MS candidate, Orthopedic Experimental Center, The Sixth Affiliated Hospital of Xinjiang Medical University, Urumqi 830002, Xinjiang Uygur Autonomous Region, China; Key Laboratory of Regenerative Medicine for Orthopedics, Xinjiang Medical University, Urumqi 830002, Xinjiang Uygur Autonomous Region, China Aikeremujiang·Muheremu and Aikebaierjiang·Aisaiti contributed equally to this work.

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摘要：


文题释义：
腰椎间盘突出症：是由于腰椎间盘纤维环破裂，髓核组织突出至硬膜外腔，压迫腰骶神经根或马尾神经，进而引发慢性下腰痛、下肢放射痛、神经功能障碍等症状的脊柱退行性疾病，严重影响患者的生活质量。传统治疗多依赖手术干预，现治疗方式逐渐转变为自发性吸收和非手术治疗。
自发性吸收：是指腰椎间盘突出物在未接受手术干预的情况下，通过机体自身生物学过程实现体积缩小甚至完全消失的现象。研究表明，自发性吸收依赖炎症反应激活、新生血管形成、巨噬细胞浸润(M1/M2 型极化调控)及基质降解等多环节协同，临床预测指标包括突出类型、MRI边缘强化厚度及后纵韧带完整性。

背景：腰椎间盘突出症是临床常见的脊柱退行性疾病，传统治疗多依赖手术干预，但腰椎间盘突出的自发性吸收现象为非手术治疗提供了全新思路。
目的：通过对1例L5/S1椎间盘重度突出患者进行为期2年的随访观察，探究综合非手术治疗方法促进突出物自发性吸收的有效性，并深入分析椎间盘自发性吸收的机制，挖掘预测吸收潜能的关键指标。
方法：选取1例L5/S1椎间盘重度突出患者，采用非类固醇抗炎药联合物理疗法及运动康复的综合非手术治疗方案，对患者进行为期2年的随访。随访过程中，密切观察患者疼痛症状变化，并通过系列MRI检查，动态记录突出物的演变过程。同时，广泛查阅大量文献，深入剖析椎间盘自发性吸收的潜在机制。
结果与结论：经过2年综合非手术治疗，患者疼痛症状显著缓解，目测类比评分明显降低，MRI清晰显示突出物逐步吸收，说明该疗法促进突出物自发性吸收有效。椎间盘自发性吸收由炎症反应激活、新生血管形成等多生物学过程协同完成，并明确突出物特征、MRI边缘强化征及后纵韧带状态为预测吸收潜能的关键指标。此外，未来可借助单细胞测序、多模态影像及深度学习技术，解析分子机制、实现早期预测并辅助临床精准治疗。综上，该综合非手术治疗方案为腰椎间盘突出症治疗提供了可靠依据，多机制协同作用明确了吸收原理，关键预测指标助力个性化方案制定，前沿技术应用则为推动腰椎间盘突出症治疗向精准化生物治疗转型、提升临床治疗水平指明了方向。
https://orcid.org/0000-0002-1690-9644 (艾克热木江·木合热木)


中国组织工程研究杂志出版内容重点：干细胞；骨髓干细胞；造血干细胞；脂肪干细胞；肿瘤干细胞；胚胎干细胞；脐带脐血干细胞；干细胞诱导；干细胞分化；组织工程

关键词: 腰椎间盘突出, 自发性吸收, 非手术管理, 保守治疗, 病例报告

Abstract: BACKGROUND:  Lumbar disc herniation is a prevalent spinal degenerative disorder in clinical practice. Traditional treatment predominantly relies on surgical intervention; however, the phenomenon of spontaneous resorption in lumbar disc herniation offers a novel non-surgical approach.
OBJECTIVE: To investigate the efficacy of a comprehensive non-surgical treatment regimen in promoting the spontaneous resorption of a severely herniated L5/S1 
disc through a two-year follow-up observation of a single patient, as well as to elucidate the mechanisms underlying disc spontaneous resorption and identify key indicators predictive of resorption potential.
METHODS: A single patient with severe L5/S1 disc herniation was selected and treated with a comprehensive non-surgical approach comprising non-steroidal anti-inflammatory drugs, physical therapy, and exercise rehabilitation. The patient was followed up for 2 years, during which changes in pain symptoms were closely monitored, and serial MRI examinations were conducted to dynamically record the evolution of the herniated material. Extensive literature review was also performed to deeply analyze the potential mechanisms of disc spontaneous resorption.
RESULTS AND CONCLUSION: After 2 years of comprehensive non-surgical treatment, the patient's pain symptoms significantly improved, with a marked reduction in the Visual Analogue Scale score. Magnetic resonance imaging clearly showed gradual resorption of the herniated material, confirming the therapeutic efficacy in promoting spontaneous resorption. The spontaneous resorption of the disc was found to be mediated by a coordinated biological process involving inflammatory response activation and neovascularization. Key indicators predictive of resorption potential were identified, including the characteristics of the herniated material, magnetic resonance imaging edge enhancement signs, and the status of the posterior longitudinal ligament. Furthermore, future research could leverage single-cell sequencing, multimodal imaging, and deep learning technologies to elucidate molecular mechanisms, realize early prediction, and assist in precise clinical treatment. In summary, this comprehensive non-surgical treatment regimen provides a reliable foundation for the management of lumbar disc herniation. The elucidation of multi-mechanism synergy clarifies the principles of resorption, while key predictive indicators facilitate the development of personalized treatment plans. The application of cutting-edge technologies points the way toward transforming the treatment of lumbar disc herniation into precise biotherapy and enhancing clinical outcomes.


Key words: lumbar disc herniation, spontaneous resorption, non-surgical management, conservative treatment, case report

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