78 research outputs found
The role of intradiscal steroids in the treatment of discogenic low back pain
LBP is one of the most common reasons for visiting a doctor and is the most common cause of disability under age 45.Amongst a variety of etiologies, internal disc disruption (IDD) has been postulated as an important cause of low back pain. Treating discogenic low back pain continues to be a challenge to physicians. Inflammation, either from direct chemical irritation or secondary to an autoimmune response to the nucleus pulposus has been implicated as the primary pain source. Both steroids and non-steroidal anti-inflammatory drugs have partial effectiveness in treating pain associated with inflammation. Therefore, the rationale for using intradiscal steroids is to suppress the inflammation within the disc, thereby alleviating the patient’s symptoms. The goal of this article is to review the literature regarding the efficacy of intradiscal steroids to treat low back pain of discogenic origin
Cervical cage without plating in management of type II / II A Hangman’s fracture combined with intervertebral disc injury
Current strategies for treatment of intervertebral disc degeneration: substitution and regeneration possibilities
Background: Intervertebral disc degeneration has an annual worldwide socioeconomic impact masked as low back pain of over 70 billion euros. This disease has a high prevalence over the working age class, which raises the socioeconomic impact over the years. Acute physical trauma or prolonged intervertebral disc mistreatment triggers a biochemical negative tendency of catabolic-anabolic balance that progress to a chronic degeneration disease. Current biomedical treatments are not only ineffective in the long-run, but can also cause degeneration to spread to adjacent intervertebral discs. Regenerative strategies are desperately needed in the clinics, such as: minimal invasive nucleus pulposus or annulus fibrosus treatments, total disc replacement, and cartilaginous endplates decalcification.
Main Body: Herein, it is reviewed the state-of-the-art of intervertebral disc regeneration strategies from the perspective of cells, scaffolds, or constructs, including both popular and unique tissue engineering approaches. The premises for cell type and origin selection or even absence of cells is being explored. Choice of several raw materials and scaffold fabrication methods are evaluated. Extensive studies have been developed for fully regeneration of the annulus fibrosus and nucleus pulposus, together or separately, with a long set of different rationales already reported. Recent works show promising biomaterials and processing methods applied to intervertebral disc substitutive or regenerative strategies. Facing the abundance of studies presented in the literature aiming intervertebral disc regeneration it is interesting to observe how cartilaginous endplates have been extensively neglected, being this a major source of nutrients and water supply for the whole disc.
Conclusion: Severalinnovative avenues for tackling intervertebral disc degeneration are being reported â from acellular to cellular approaches, but the cartilaginous endplates regeneration strategies remain unaddressed. Interestingly, patient-specific approaches show great promise in respecting patient anatomy and thus allow quicker translation to the clinics in the near future.The authors would like to acknowledge the support provided by the Portuguese
Foundation for Science and Technology (FCT) through the project EPIDisc
(UTAP-EXPL/BBBECT/0050/2014), funded in the Framework of the “International
Collaboratory for Emerging Technologies, CoLab”, UT Austin|Portugal Program.
The FCT distinctions attributed to J. Miguel Oliveira (IF/00423/2012 and IF/01285/
2015) and J. Silva-Correia (IF/00115/2015) under the Investigator FCT program are
also greatly acknowledged.info:eu-repo/semantics/publishedVersio
Comparison of expandable and fixed interbody cages in a human cadaver corpectomy model, Part I: endplate force characteristics
Flexibility and fatigue evaluation of oblique as compared with anterior lumbar interbody cages with integrated endplate fixation
Preoperative epidural spinal injections increase the risk of surgical wound complications but do not affect overall complication risk or patient-perceived outcomes
Biomechanical evaluation of the ventral and lateral surface shear strain distributions in central compared with dorsolateral placement of cages for lumbar interbody fusion
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