Updates on Pathophysiology of Discogenic Back Pain

Jha, Rohan; Bernstock, Joshua D.; Chalif, Joshua I.; Hoffman, Samantha E.; Gupta, Saksham; Guo, Hong; Lu, Yi

doi:10.3390/jcm12216907

Cited by 6 publications

(2 citation statements)

References 167 publications

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“…Inflammatory mediators contribute to the deterioration of the intervertebral disc structure, leading to annular fibrosis [18]. Additionally, they promote the formation of new blood vessels, nerve innervation, and sensitization, ultimately resulting in pain transmission [19]. Based on anatomical studies, Chen et al have proposed a significant role for the sinuvertebral nerve in back pain transmission [20].…”

Section: Discussionmentioning

confidence: 99%

A new technique for low back pain in lumbar disc herniation: percutaneous endoscopic lumbar discectomy combined with sinuvertebral nerve ablation

Huang,

Wei,

Shen

et al. 2024

J Orthop Surg Res

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Background Percutaneous endoscopic lumbar discectomy (PELD) has demonstrated efficacy in alleviating leg pain among patients with lumbar disc herniation. Nonetheless, residual back pain persists as a troubling issue for surgeons following the procedure. In the treatment of discogenic back pain, sinuvertebral nerve radiofrequency ablation has shown promising results. Nevertheless, the potential benefit of simultaneously implementing sinuvertebral nerve radiofrequency ablation during PELD surgery to address residual back pain has not been thoroughly investigated in current literature. Methods This retrospective study reviewed Lumbar disc herniation (LDH) patients with low back pain who underwent combined PELD and sinuvertebral nerve ablation in our department between January 2021 and September 2023. Residual low back pain post-surgery was assessed and compared with existing literature. Results A total of 80 patients, including 53 males and 27 females, were included in the study. Following surgical intervention, patients demonstrated remarkable improvements in pain and functional parameters. One month post-operatively, the VAS score for low back pain exhibited a 75% reduction (6.45 ± 1.3 to 1.61 ± 1.67), while the VAS score for leg pain decreased by 85% (7.89 ± 1.15 to 1.18 ± 1.26). Notably, the JOA score increased from 12.89 ± 5.48 to 25.35 ± 4.96, and the ODI score decreased form 59.48 ± 9.58 to 20.3 ± 5.37. These improvements were sustained at three months post-operatively. According to the modified Mac Nab criteria, the excellent and good rate was 88.75%. Residual low back pain is observed to be comparatively reduced compared to the findings documented in earlier literature. Conclusion The combination of percutaneous endoscopic lumbar discectomy and sinuvertebral nerve ablation demonstrates effective improvement in low back pain for LDH patients.

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Section: Discussionmentioning

confidence: 99%

A new technique for low back pain in lumbar disc herniation: percutaneous endoscopic lumbar discectomy combined with sinuvertebral nerve ablation

Huang,

Wei,

Shen

et al. 2024

J Orthop Surg Res

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“…-discogenic pain), або «дискогенний біль у спині» (англ. -discogenic back pain) та їхні локалізаційні похідні [39,41];…”

Section: перший клас включає відомі клінічні терміниunclassified

Degenerative Intervertebral Disc Disease: Difficulties in Definition of the Concept and Epidemiology of the Phenomenon. Brief Communication

Medvediev,

Marushchenko,

Tsymbaliuk

2023

Clin. and prev. med.

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The aim. The significant prevalence of intervertebral discs chronic pathology in the human population against the background of the lack of a clear and unified definition of the concept of «degenerative [intervertebral] disc disease» (DDD) creates difficulties in the study and formation of treatment protocols for this pathology. This study aims to clarify the epidemiological characteristics and terminological features of the pathology of the intervertebral discs covered by the term «DDD». Materials and methods. A systematic search in pubmed and related scientific and professional databases for publications devoted to DDD’s terminological features and epidemiology was conducted. In the analysis, the papers in which DDD and semantically related concepts and clinical phenomena are included as the primary research objects. Results. Based on the analysis, it is found that there is no unified defining the concept of DDD, which includes both initial degenerative changes in the disc, regardless of the manifestation of the pain syndrome, and conditions with a clear pathomorphological picture, such as intervertebral disc herniation, degenerative spinal stenosis, etc. DDD is pathophysiological and conventional; its list of pathomorphological and clinical correlates still needs to be completed. Clinical phenomena, considered the most certain correlates of DDD, can be caused by other pathological processes. Currently, the only but somewhat inaccurate indicator of the prevalence of back pain in the human population is the epidemiological characteristic of back pain, which, according to available calculations, can reach 800 million people at any given time, i.e., 10 % of the human population. Uncertainty regarding the semantics of the term DDD makes it challenging to unify research results and develop effective clinical protocols. Conclusions. The meaning of the term DDD remains unclear and non-unified, and the epidemiological characteristics of the phenomenon of back pain can only be used with significant caution for a rough estimate of the prevalence of clinically significant forms of ddd. Unifying and clarifying terminology, prevalence, and identification of benchmark etiological factors of DDD will allow to improve treatment protocols for this pathology and improve its results.

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Tnfaip8 and Tipe2 Gene Deletion Ameliorates Immediate Proteoglycan Loss and Inflammatory Responses in the Injured Mouse Intervertebral Disc

Lu,

Tian,

Shofer

et al. 2024

Am J Phys Med Rehabil

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OBJECTIVE TNFAIP8 and TIPE2 belong to TNFa-induced protein 8 (TNFAIP8/TIPE) family. They control apoptosis and direct leukocyte migration. Nucleus pulposus (NP) cell loss is a hallmark of intervertebral disc (IVD) degeneration in response to injury, and inflammation may cause pain. Here, we examined the effects of TNFAIP8/TIPE2 deficiency on the IVDs in mice with these genes deleted. Design Tail IVDs in Tnfaip8 or Tipe2 single and double knockout mice (Tnfaip8-/- , Tipe2-/- , and Tnfaip8/Tipe2 dko), and wild type (WT) controls were injured. The spine motion segments were stained with Safranin O to reveal proteoglycans. Macrophages were identified by immunostaining, and selected inflammatory marker and collagen gene expression was examined by Real Time PCR. RESULTS The injured tail IVDs of Tnfaip-/- , Tipe2-/- , and Tnfaip8/Tipe2 dko mice all displayed higher levels of proteoglycans than WT controls. Fewer macrophages were found in the injured IVDs of Tipe2-/- and Tnfaip8/Tipe2 dko mice than WT. Il6, Adam8 and Col1 gene expression was downregulated in the injured IVDs of Tnfip8/Tipe2 dko mice. CONCLUSIONS TNFAIP8 and TIPE2 loss of function ameliorated proteoglycan loss and inflammation in the injured IVDs. They may serve as molecular targets to preserve disc structure and reduce inflammation.

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Updates on Pathophysiology of Discogenic Back Pain

Cited by 6 publications

References 167 publications

A new technique for low back pain in lumbar disc herniation: percutaneous endoscopic lumbar discectomy combined with sinuvertebral nerve ablation

A new technique for low back pain in lumbar disc herniation: percutaneous endoscopic lumbar discectomy combined with sinuvertebral nerve ablation

Degenerative Intervertebral Disc Disease: Difficulties in Definition of the Concept and Epidemiology of the Phenomenon. Brief Communication

Tnfaip8 and Tipe2 Gene Deletion Ameliorates Immediate Proteoglycan Loss and Inflammatory Responses in the Injured Mouse Intervertebral Disc

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