The lumbar degenerative disc: confusion, mechanics, management.

Paper

The lumbar degenerative disc: confusion, mechanics, management.

Published 2006 · P. K. Kim, C. Branch

Clinical neurosurgery

UNKNOWN SJR score

13

Citations

0

Influential Citations

Semantic Scholar

Abstract

The lumbar disc represents a complex biological ecosystem dependent on a homeostatic environment. Consistent with a natural ecosystem, demise and degeneration occurs as a consequence of one or a combination of environmental disruptions. With this understanding, we must move away from the general term “degenerative disc disease” (DDD) and move toward the determination of etiology-specific conditions and the development of etiology-specific preventative or therapeutic strategies. Our vision must be the optimization of treatment outcomes for specific conditions of the lumbar disc and the implementation of degeneration prevention strategies through genetic or tissue engineering or other biologic modalities. Confusion A major source of confusion in the universe of spine care is the reality that the scientific literature contains multiple, widely different and expensive therapeutic algorithms, which have been established as successful in the treatment of the ambiguous, all-inclusive lumbar DDD. Current options range from non-invasive, purportedly less expensive structured physical therapy and the popular, widely used chiropractic manipulation to the invasive, purportedly more expensive discectomy and fusion, and, most recently, disc replacement therapy.

Study Snapshot

Key takeawayThis confusion stems from the fact that multiple, expensive therapeutic algorithms have been established as successful in treating lumbar degenerative disc disease, with no clear consensus on which approach is most effective.

PopulationOlder adults (50-71 years)

Sample size24

MethodsObservational

OutcomesBody Mass Index projections

ResultsSocial networks mitigate obesity in older groups.

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The lumbar degenerative disc: confusion, mechanics, management.

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References

Disc Arthroplasty in the Management of the Painful Lumbar Motion Segment

Lumbar disc arthroplasty provided clinical results similar to interbody fusion at 2 years in appropriately selected patients, but long-term effects on adjacent segment degeneration remain unclear.

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Lumbar total disc replacement with the CHARITÉTM artificial disc is a safe and effective alternative to lumbar fusion for treating symptomatic disc degeneration, with higher patient satisfaction and shorter hospital stays.

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LMP-1 overexpression in intervertebral disc cells increases proteoglycan, BMP-2, and BMP-7 production, mediating the control of proteoglycan production through its action on BMPs.

Citations

Assessment and Determinants of Spinal Pain in the Course of Disc Disorders Treated Surgically

Surgical treatment significantly reduces pain in patients with disc disorders, with pain levels primarily affected by the location of hernia and the type of work performed by the patient.

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Back pain is one of the most common pain symptoms, and controlling it can improve the health and wealth of society.

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Healthy discs maintain higher residual stress values and stress relaxation, while degenerated discs lose this ability over time.

Mechanical loading affects the energy metabolism of intervertebral disc cells

Static and dynamic compressive loading affect intervertebral disc cell energy production, with cell type and compression type-dependent responses.