Management of Symptomatic Lumbar Degenerative Disk Disease

Madigan, Luke; Vaccaro, Alexander R.; Spector, Leo R.; Milam, R. Alden

doi:10.5435/00124635-200902000-00006

Cited by 70 publications

(42 citation statements)

References 66 publications

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“…Conventional treatments such as nonsteroidal antiinflammatory drugs (NSAIDs) provide effective short-term back pain relief but do not alter the progression of disc degeneration [55,76]. There is conflicting evidence about the effects of NSAIDs on intervertebral disc tissues.…”

Section: Oral Treatmentsmentioning

confidence: 99%

Molecular Basis of Intervertebral Disc Degeneration and Herniations: What Are the Important Translational Questions?

Kadow

Sowa

et al. 2015

Clinical Orthopaedics &Amp; Related Research

217

197

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Background Intervertebral disc degeneration is a common condition with few inexpensive and effective modes of treatment, but current investigations seek to clarify the underlying process and offer new treatment options. It will be important for physicians to understand the molecular basis for the pathology and how it translates to developing clinical treatments for disc degeneration. In this review, we sought to summarize for clinicians what is known about the molecular processes that causes disc degeneration.

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Section: Oral Treatmentsmentioning

confidence: 99%

Molecular Basis of Intervertebral Disc Degeneration and Herniations: What Are the Important Translational Questions?

Kadow

Sowa

et al. 2015

Clinical Orthopaedics &Amp; Related Research

217

197

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“…The label "lumbar degenerative disc disease (DDD)" has also been criticized. The label of DDD, applied with ambiguous definition, might be a cause of overuse of spinal fusion 7) . The label "muscle strain" is criticized because of its ambiguity.…”

Section: Criticism On Diagnostic Labelmentioning

confidence: 99%

The Recent Trend in Diagnosis and Treatment of Chronic Low Back Pain

Kikuchi

2017

Spine Surg Relat Res

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Abstract:Introduction: Development of evidence-based medicine has made a big change in diagnosis and treatment of chronic low back pain. The recent trend is assessed through a review of literature. Methods: The articles published in these 10 years are reviewed, and important points are examined. Results: In diagnosis, challenges for history taking and limit of imaging or clinical guidelines are revealed. In treatment, cognitive behavioral treatment and exercises are proved effective. Sleep disturbance has recently attracted attention as a factor associated with low back pain. Cost-effectiveness of diagnosis and treatment modalities has come to be emphasized. Conclusions: Diagnosis and treatment of chronic low back pain have been significantly changing. Multidisciplinary and multidimensional approach is essential. Chronic low back pain should be treated as a total pain, not a local pain.

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“…Normally, one vertebral endplate has two nerve supplies: one enters the endplate along with perivertebral blood vessels, while the other that belongs to the sinuvertebral nerve branch that enters the endplate through the intervertebral foramen. The nerve density within the endplate is similar to that of the annulus, indicating that the endplate is also an important source of discogenic low back pain [84].The natural history of discogenic back pain is that 90% of patients will experience improvement of their symptoms within 6weeks and resolution by 3 months with or without treatment and 20% will experience recurrent pain within 6months [85,86]. The mechanism of radiculopathy related pain production has been of considerable debate.…”

mentioning

confidence: 98%

Etiology and Risk Factors of Lumbar Intervertebral Disc (IVD) Degeneration

Debnath¹

2018

RMES

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Biological factors (Table 1) Changes in ECM (Extracellular Matrix): Collagen synthesis increases in the initial stages of degeneration with a clear increase in type II Collagen in the NP (maybe indicating repair mechanism) [9]. As the degeneration progresses the synthesis pattern changes and more type II Collagen is synthesized in AF. Type I collagen is synthesized in the deep region of AF and NP. Type X collagen formation is associated with chondrocyte agglomerates and tears of degenerated IVDs. The synthesis of proteoglycans also changes with decline in production of aggrecan and increase in the synthesis of versican, biglycan and decorin. There is reduced Glycosaminoglycans (GAGs) esp. modification of chondroitin sulfate to keratan sulfate. These results in disc desiccation and degeneration [10]. The remodeling of the ECM results from these changes occurring simultaneously. The protagonists of the process are the matrix metallo-proteinases (MMPs) [11]. There are ADAMTS (a desintegrin and metalloproteinase with thrombospondin), which play similar but more powerful roles like MMPs. Both these families have the same endogenous inhibitors called TIMPs (Tissue inhibitor matrix metallo-proteinases), which act synergistically in the remodeling of ECM [12]. Review Article Research in Medical & Engineering Sciences C CRIMSON PUBLISHERS Wings to the Research 1/10Copyright © All rights are reserved by Ujjwal K Debnath. Volume 4 -Issue 5 ISSN: 2576-8816 AbstractLumbar degenerative disc disease (DDD) is a progressive condition that exists along a continuum of pathologic processes. The disease starts as desiccation of the nucleus pulposus, to annular tearing, diffuse disc bulging, and disc space collapse, the degenerative process can occur over the course of decades, culminating in substantial debilitation. Clinically DDD presents with back pain and/or radiculopathy, can limit work and productivity. Additionally, the cost of treating this condition is especially high, and billions of dollars are spent on managing degenerative spinal processes annually.In this review, the main focus is on the recent advances in studies on the most extensively examined risk factors and genetic factors associated with DDD in humans. A number of genetic defects have been correlated with structural and functional changes within the intervertebral disc (IVD), which may compromise the disc's mechanical properties and metabolic activities. These studies have begun to shed light on the molecular basis of DDD, suggesting that genetic factors are important contributors to the onset and progression of IDD. By continuing to improve our understanding of the molecular mechanisms of DDD, specific early diagnosis and more effective treatments for this disabling disease may be possible in the future. Res Med Eng Sci 2/10How Proinflammatory cytokinesMost important cytokines which influences the IVD degeneration process are Interleukin -1 (IL-1) and Tumor necrosis factor-α (TNF-α). Large volumes of research and evidence suggest these cytokines are directly ...

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Management of Symptomatic Lumbar Degenerative Disk Disease

Cited by 70 publications

References 66 publications

Molecular Basis of Intervertebral Disc Degeneration and Herniations: What Are the Important Translational Questions?

Molecular Basis of Intervertebral Disc Degeneration and Herniations: What Are the Important Translational Questions?

The Recent Trend in Diagnosis and Treatment of Chronic Low Back Pain

Etiology and Risk Factors of Lumbar Intervertebral Disc (IVD) Degeneration

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