Distribution Patterns of Degeneration of the Lumbar Spine in a Cohort of 200 Patients with an Indication for Lumbar MRI

Näther, Philipp; Kersten, Jan Felix; Kaden, Ingmar; Irga, Kemal; Nienhaus, Albert

doi:10.3390/ijerph19063721

Cited by 7 publications

(2 citation statements)

References 40 publications

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“…Experimental studies indicate a displacement of the material “bulging” of the nucleus pulposus in the dorsal direction, which in turn leads to protrusion and the formation of a hernia [ 81 ].…”

Section: Discussionmentioning

confidence: 99%

Development of a Computational Model of the Mechanical Behavior of the L4–L5 Lumbar Spine: Application to Disc Degeneration

et al. 2022

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Degenerative changes in the lumbar spine significantly reduce the quality of life of people. In order to fully understand the biomechanics of the affected spine, it is crucial to consider the biomechanical alterations caused by degeneration of the intervertebral disc (IVD). Therefore, this study is aimed at the development of a discrete element model of the mechanical behavior of the L4–L5 spinal motion segment, which covers all the degeneration grades from healthy IVD to its severe degeneration, and numerical study of the influence of the IVD degeneration on stress state and biomechanics of the spine. In order to analyze the effects of IVD degeneration on spine biomechanics, we simulated physiological loading conditions using compressive forces. The results of modeling showed that at the initial stages of degenerative changes, an increase in the amplitude and area of maximum compressive stresses in the disc is observed. At the late stages of disc degradation, a decrease in the value of intradiscal pressure and a shift in the maximum compressive stresses in the dorsal direction is observed. Such an influence of the degradation of the geometric and mechanical parameters of the tissues of the disc leads to the effect of bulging, which in turn leads to the formation of an intervertebral hernia.

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Section: Discussionmentioning

confidence: 99%

Development of a Computational Model of the Mechanical Behavior of the L4–L5 Lumbar Spine: Application to Disc Degeneration

et al. 2022

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“…As the lumbar spine is one of the most loaded tissues in the body, tissue tolerance is likely an important concept for understanding NSLBP (Chau, 2022). Shear stresses are highest in the lower lumbar spine (Keller et al., 2005), which likely explains the higher degree of degeneration found at these levels (Näther et al., 2022). Lastly, there is a genetic component of LBP with its heritability estimated to be between 21% and 67%.…”

Section: Aetiology Of Nslbpmentioning

confidence: 99%

Personalized assessment and management of non‐specific low back pain

Wirth,

Schweinhardt

2023

European Journal of Pain

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Background and ObjectiveLow back pain (LBP), and in particular non‐specific low back pain (NSLBP), which accounts for approximately 90% of LBP, is the leading cause of years lived with disability worldwide. In clinical trials, LBP is often poorly categorized into ‘specific’ versus ‘non‐specific’ and ‘acute’ versus ‘chronic’ pain. However, a better understanding of the underlying pain mechanisms might improve study results and reduce the number of NSLBP patients.Databases and Data TreatmentNarrative review.ResultsNSLBP is a multi‐dimensional, biopsychosocial condition that requires all contributing dimensions to be assessed and prioritized. Thereby, the assessment of the contribution of nociceptive, neuropathic and nociplastic pain mechanisms forms the basis for personalized management. In addition, psychosocial (e.g. anxiety, catastrophizing) and contextual factors (e.g. work situation) as well as comorbidities need to be assessed and individually weighted. Personalized treatment of NSLBP further requires individually choosing treatment modalities, for example, exercising, patient education, cognitive‐behavioural advice, pharmacotherapy, as well as tailoring treatment within these modalities, for example, the delivery of tailored psychological interventions or exercise programs. As the main pain mechanism and psychosocial factors may vary over time, re‐assessment is necessary and treatment success should ideally be assessed quantitatively and qualitatively.ConclusionsThe identification of the main contributing pain mechanism and the integration of the patients' view on their condition, including beliefs, preferences, concerns and expectations, are key in the personalized clinical management of NSLBP. In research, particular importance should be placed on accurate characterization of patients and on including outcomes relevant to the individual patient.Significance StatementHere, a comprehensive review of the challenges associated with the diagnostic label ‘non‐specific low back pain’ is given. It outlines what is lacking in current treatment guidelines and it is summarized what is currently known with respect to individual phenotyping. It becomes clear that more research on clinically meaningful subgroups is needed to best tailor treatment approaches.

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Knowledge Areas and New Trends in Lumbar Disc Herniation Research: Bibliometrics and Knowledge Mapping Analysis

Wang

Tang

Zhang

et al. 2022

JOIO

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Distribution Patterns of Degeneration of the Lumbar Spine in a Cohort of 200 Patients with an Indication for Lumbar MRI

Cited by 7 publications

References 40 publications

Development of a Computational Model of the Mechanical Behavior of the L4–L5 Lumbar Spine: Application to Disc Degeneration

Development of a Computational Model of the Mechanical Behavior of the L4–L5 Lumbar Spine: Application to Disc Degeneration

Personalized assessment and management of non‐specific low back pain

Knowledge Areas and New Trends in Lumbar Disc Herniation Research: Bibliometrics and Knowledge Mapping Analysis

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