Treatment of Discogenic Low Back Pain: Current Treatment Strategies and Future Options—a Literature Review

Zhao, Liang; Manchikanti, Laxmaiah; Kaye, Alan D.; Abd‐Elsayed, Alaa

doi:10.1007/s11916-019-0821-x

Cited by 95 publications

(79 citation statements)

References 92 publications

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“…Lower-back pain (LBP) and sciatica inflict a significant socioeconomic burden nowadays as well as disabling the affected patients [ 1 , 2 , 3 , 4 , 5 , 6 , 7 , 8 , 9 , 10 ]. As reviewed by various authors approximately 80% of the population sustains an episode of LBP once during their lifetime, consequently incurring an annual cost of more than USD 100 billion in the United States of America [ 11 , 12 , 13 ].…”

Section: Introductionmentioning

confidence: 99%

Online Videos as a Source of Physiotherapy Exercise Tutorials for Patients with Lumbar Disc Herniation—A Quality Assessment

Heisinger

Huber

Matzner

et al. 2021

IJERPH

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Background: During the last few decades the prevalence of lumbar disc herniation has been increasing constantly, thereby imposing a significant socioeconomic burden. Physiotherapy plays a crucial role in both surgical and conservative treatment of lumbar disc herniation, consequently the current COVID-19 pandemic with concomitant lockdowns has led to a shortage of physiotherapeutical care. In the light of these recent events publicly available physiotherapy tutorials may be a useful tool to address this problem. Aim: The main aim of this study was to assess the quality of online physiotherapy exercise tutorials for lumbar disc herniation. Materials & Methods: With YouTube being a widely known and used platform we screened 240 of the most viewed videos. A total of 76 videos met the inclusion criteria and were statistically analyzed. The videos were assessed using Global Quality Score, DISCERN Score and JAMA benchmark criteria and in regard to their applicability. Results: They displayed a wide range of views (44,969 to 5,448,717), likes (66 to 155,079) and dislikes (6 to 2339). The videos were assessed using Global Quality Score, DISCERN Score and JAMA benchmark criteria and in regard to their applicability. Neither the number of “Views”, “Likes”, nor “Dislikes” was found to have a significant association with any of the quality measures used in this study. Conclusion: Overall quality grade was determined as “moderate”. Based on the data examined in this study, the use of YouTube videos as a source of therapy advice for lumbar spine disc herniation cannot be recommended universally.

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Section: Introductionmentioning

confidence: 99%

Online Videos as a Source of Physiotherapy Exercise Tutorials for Patients with Lumbar Disc Herniation—A Quality Assessment

Heisinger

Huber

Matzner

et al. 2021

IJERPH

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show abstract

“…Eleven articles were review papers. [34][35][36][37][38][39][40][41][42][43][44] Two patients were reported to have major complications. Subach et al 24 published a case report of a patient treated at an outside institution with an autologous adipose graft and BMC with resultant cauda equina syndrome secondary to spondylodiscitis and epidural abscess.…”

Section: Resultsmentioning

confidence: 99%

Risks of Intradiscal Orthobiologic Injections: A Review of the Literature and Case Series Presentation

Jerome¹,

Lutz

2021

Int J Spine Surg

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Background: Intervertebral disc disease (IDD) is responsible for a large portion of back pain with historically suboptimal treatments for long-term improvement. IDD pathogenesis is thought to arise at a cellular and biochemical level, making biologically based injections an area of clinical interest. Although human studies have shown promise, emerging data suggest there may be risks inherent to such injections that were previously unrecognized. The aim of this review is to summarize the known risks to date and provide mitigation steps to reduce potential complications in the future. In addition, we present a small case series of serious adverse events (SAEs) from our clinical practice.Methods: A literature review was performed to identify human intradiscal autologous biologic injection studies to date, including mesenchymal signaling cells (MSCs) and platelet-rich plasma (PRP) preparations, which were reviewed for complications. Cases of complication following intradiscal orthobiologic injection were identified from a single outpatient center and reviewed.Results: Publications of MSC-based intradiscal injection documented 136 total patients treated with two SAEs reported, one infection and one progressive disc herniation. Publications of PRP intradiscal injection included 194 patients with one SAE reported. We also review three cases of previously unpublished SAEs, including one case of confirmed infection with Cutibacterium acnes (C acnes) and two presumed cases of discitis without pathogen confirmation. Bone marrow concentrate was the injectate in all three cases.Conclusions: Although biologic intradiscal injection shows promise for the treatment of discogenic back pain, there are inherent risks to be considered and mitigated. We currently recommend a leukocyte-rich PRP and a two-needle delivery technique coupled with intradiscal gentamicin to mitigate the risk of postinjection spondylodiscitis. Further research is needed using large registries to not only track clinical outcomes but also complication rates.

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“…Treatment methods such as physical therapy, non-steroidal anti-inflammatory drugs (NSAIDs), and steroid injections are commonly used for alleviating discogenic pain. 5,6 However, neither operative nor nonoperative treatment methods actually address the underlying disease.…”

Section: Introductionmentioning

confidence: 99%

Pathomechanism and Biomechanics of Degenerative Disc Disease: Features of Healthy and Degenerated Discs

et al. 2021

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The human intervertebral disc (IVD) is a complex organ composed of fibrous and cartilaginous connective tissues, and it serves as a boundary between 2 adjacent vertebrae. It provides a limited range of motion in the torso as well as stability during axial compression, rotation, and bending. Adult IVDs have poor innate healing potential due to low vascularity and cellularity. Degenerative disc disease (DDD) generally arises from the disruption of the homeostasis maintained by the structures of the IVD, and genetic and environmental factors can accelerate the progression of the disease. Impaired cell metabolism due to pH alteration and poor nutrition may lead to autophagy and disruption of the homeostasis within the IVD and thus plays a key role in DDD etiology. To develop regenerative therapies for degenerated discs, future studies must aim to restore both anatomical and biomechanical properties of the IVDs. The objective of this review is to give a detailed overview about anatomical, radiological, and biomechanical features of the IVDs as well as discuss the structural and functional changes that occur during the degeneration process.

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Treatment of Discogenic Low Back Pain: Current Treatment Strategies and Future Options—a Literature Review

Cited by 95 publications

References 92 publications

Online Videos as a Source of Physiotherapy Exercise Tutorials for Patients with Lumbar Disc Herniation—A Quality Assessment

Online Videos as a Source of Physiotherapy Exercise Tutorials for Patients with Lumbar Disc Herniation—A Quality Assessment

Risks of Intradiscal Orthobiologic Injections: A Review of the Literature and Case Series Presentation

Pathomechanism and Biomechanics of Degenerative Disc Disease: Features of Healthy and Degenerated Discs

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