Novelties in etiopathogenesis, diagnosis and treatment of patients with lumbar intevrertebral disc degeneration

Abstract

. Low-back pain is one of the most common causes of physical disability, most often originating from intervertebral disc degeneration. Lack of pinpointing the exact source of pain is the limiting factor in more efficient prevention and treatment. New findings, especially in the fields of genetics and mass spectometry based protein analysis, shed a new light to the understanding of etiopathogenesis of disc degenerative disease. New imaging methods like chemical exchange saturation transfer (CEST)MRI or apparent diffusion coefficient (ADC)MRI can detect early degenerative changes. Advances have been made regarding elucidating the role of physical load, as well as the type of exercise that can have an impact on the development and treatment of patients with degenerative disc disease. Finally, a significant progress has been made in the surgical treatment ecouraging of these patients, with an emphasis on minimally invasive techniques. Other surgical modalities have also shown improvement, like total disc replacement and mesenchymal stem cells treatments. These, and other novelties in the diagnosis and treatment of degenerative disc disease of lumbar spine are discussed in this article.

Keywords

• intervertebral disc degeneration – complications
• diagnostic imaging
• etiology
• physiopathology
• surgery; low back pain – etiology
• therapy; lumbar vertebrae – surgery; intervertebral disc displacement – complications