On the experimental intradiscal pressure measurement techniques : a review

Series : Mechanisms and machine science, ISSN 2211-0984, vol. 24The intradiscal pressure has been essential for prevent the spinal complaints by forming a basis for clinical advice to promote the correct sitting postures. As a consequence, it is evident the need of an accurate method for measure the intradiscal pressure, to better understand the disc response to hydorstatic pressure fluctuations. Numerous reviews regarding disc mechanics are available, including intradiscal pressure benchmarks; however, an analysis on the techniques of intradiscal pressure measurement is needed. Therefore, this review will remain focused on the methodologies adopted for measure the intradiscal pressure in several conditions: for different daily activities, under external loads and for values where occurs annulus fibrosus disruption. The importance of the intradiscal pressure on disc function will be discussed as well as the some guidelines for design new measurement techniques will be defined

Investigation of the in-vitro loading on an artificial spinal disk prosthesis

Spinal diseases imposes considerable burden to both patients and society. In recent years, much surgical efforts have been made in advancing the treatment of neck and back pain. Of particular prominence is the increasing clinical acceptance and use of intervertebral artificial disk prosthesis for the treatment of discogenic back pain. Despite this increased use of such disks, their in-vivo monitoring remains rudimentary. In an effort to develop an intelligent artificial spinal disk where the in-vivo loading of the spine can by studied for the first time an experimental set up has been created in order to initially study the in-vitro loading on an artificial disc prosthesis. Eight strain gauges and two piezoresistive sensors were used and placed suitably in the artificial disk prosthesis. The results from the in-vitro loading showed linear relationship between loading and the outputs from the sensors with good repeatability and less hysteresis

Biomechanical experimental data curation: an example for main lumbar spine ligaments characterization for a MBS spine model

Series : Mechanisms and machine science, ISSN 2211-0984, vol. 24This work overviews an extensive analysis in the context of mechanical characterization of human biomaterials, carried out over a broad set of published experimental data. Focused on main lumbar spine ligaments, several test procedures are exhaustively analyzed, in order to identify possible causes for divergences that have been found in some results. Moreover, guidelines are proposed for da-ta filtering and selection. The main objective of the task was to retrieve trustworthy inputs to a hybrid Finite Element Analysis / Multibody System dynamic simulation model of the human intervertebral disc, which can be used on the prediction of nucleus prosthetics working performance

Are you sitting comfortably? The political economy of the body

The aim of this paper is to examine the relationship between the mass production of furniture in modern industrial societies and lower back pain (LBP). The latter has proven to be a major cost to health services and private industry throughout the industrialised world and now represents a global health issue as recent WHO reports on obesity and LBP reveal. Thus far there have been few co-ordinated attempts to deal with the causes of the problem through public policy. Drawing upon a range of sources in anthropology, health studies, politics and economics, the paper argues that this a modern social problem rooted in the contingent conjuncture of natural and social causal mechanisms. The key question it raises is: what are the appropriate mechanisms for addressing this problem? This paper develops an analysis rooted in libertarian social theory and argues that both the state and the capitalist market are flawed mechanisms for resolving this problem. There remains a fundamental dilemma for libertarians, however. Whilst the state and the market may well be flawed mechanisms, they are the dominant ones shaping global political economy. To what extent can libertarians work within these structures and remain committed to libertarian goals

TNF-α Promotes Nuclear Enrichment of TonEBP/NFAT5 to Selectively Control Inflammatory but not Osmoregulatory Responses in Nucleus Pulposus Cells.

Intervertebral disc degeneration (IDD) causes chronic back pain and is linked to production of proinflammatory molecules by nucleus pulposus (NP) and other disc cells. Activation of TonicityResponsive Enhancer-Binding Protein (TonEBP)/NFAT5 by non-osmotic stimuli, including pro-inflammatory molecules, occurs in cells involved in immune response. However, whether inflammatory stimuli activate TonEBP in NP cells and if TonEBP controls inflammation during IDD is unknown. We show that TNF-α, but not IL-1β or LPS, promoted nuclear enrichment of TonEBP protein. However, TNF-α-mediated activation of TonEBP did not cause induction of osmo-regulatory genes. RNA-sequencing showed that 8.5% of TNF-α transcriptional responses were TonEBP-dependent and identified genes regulated by both TNF-α and TonEBP. These genes were over-enriched in pathways and diseases related to Inflammatory Response and Inhibition of Matrix Metalloproteases. Based on RNA-seq results, we further investigated regulation of novel TonEBP targets CXCL1, CXCL2, and CXCL3. TonEBP acted synergistically with TNF-α and LPS to induce CXCL1 proximal promoter activity. Interestingly, this regulation required a highly conserved NF-κB binding site but not a predicted TonE, suggesting crosstalk between these two members of the Rel family. Finally, analysis of human NP tissue showed that TonEBP expression correlated with canonical osmo-regulatory targets TauT/SLC6A6, SMIT/SLC5A3, and AR/AKR1B1, supporting in vitro findings that the inflammatory milieu during IDD does not interfere with TonEBP osmoregulation. In summary, while TonEBP participates in the pro-inflammatory response to TNF-α, therapeutic strategies targeting this transcription factor for treatment of disc disease must spare osmo-protective, pro-survival, and matrix homeostatic activities. [Abstract copyright: Copyright © 2017, The American Society for Biochemistry and Molecular Biology.

The Virtual-Spine Platform—Acquiring, visualizing, and analyzing individual sitting behavior

Back pain is a serious medical problem especially for those people sitting over long periods during their daily work. Here we present a system to help users monitoring and examining their sitting behavior. The Virtual-Spine Platform (VSP) is an integrated system consisting of a real-time body position monitoring module and a data visualization module to provide individualized, immediate, and accurate sitting behavior support. It provides a comprehensive spine movement analysis as well as accumulated data visualization to demonstrate behavior patterns within a certain period. The two modules are discussed in detail focusing on the design of the VSP system with adequate capacity for continuous monitoring and a web-based interactive data analysis method to visualize and compare the sitting behavior of different persons. The data was collected in an experiment with a small group of subjects. Using this method, the behavior of five subjects was evaluated over a working day, enabling inferences and suggestions for sitting improvements. The results from the accumulated data module were used to elucidate the basic function of body position recognition of the VSP. Finally, an expert user study was conducted to evaluate VSP and support future developments

Total disc replacement for chronic back pain in the presence of disc degeneration

Scientific Assessment and Innovation in Neurosurgical Treatment Strategie

Consultations with complementary and alternative medicine practitioners amongst wider care options for back pain: a study of a nationally representative sample of 1,310 Australian women aged 60–65 years

Back pain is a significant health service issue in Australia and internationally. Back pain sufferers can draw upon a range of health care providers including complementary and alternative medicine (CAM) practitioners. Women are higher users of health services than men and tend to use CAM frequently for musculoskeletal conditions. However, there remain important gaps in our understanding of women's consultation patterns with CAM practitioners for back pain. The objective of this study is to examine the prevalence of use and characteristics of women who use CAM practitioners for back pain. The method used was a survey of a nationally representative sample of women aged 60-65 years from the Australian Longitudinal Study on Women's Health. Women consulted a massage therapist (44.1 %, n = 578) and a chiropractor (37.3 %, n = 488) more than other CAM practitioners for their back pain. Consultations with a chiropractor for back pain were lower for women who consulted a General Practitioner (GP) (OR, 0.56; 95 % CI 0.41, 0.76) or a physiotherapist (OR, 0.53; 95 % CI 0.39, 0.72) than for those who did not consult a GP or a physiotherapist. CAM practitioner consultations for back pain were greater for women who visited a pharmacist (OR, 1.99; 95 % CI 1.23, 3.32) than for women who did not visit a pharmacist. There is substantial use of CAM practitioners alongside conventional practitioners amongst women for back pain, and there is a need to provide detailed examination of the communication between patients and their providers as well as across the diverse range of health professionals involved in back pain care

Symptom increase following a functional capacity evaluation in patients with chronic low back pain:An explorative study of safety

Introduction: This study was performed to study intensity and duration of symptom increase following an FCE and to explore safety of an FCE. Methods: Included were 92 patients with chronic low back pain (CLBP), mean age 38.5 years, mean self-reported disability 12.5 (Roland Morris Disability Questionnaire). All patients underwent an FCE. Symptom increase was measured with a 2-item questionnaire. Operational definition for safety: no formal complaint filed and symptom increase to occur only temporarily. Results: No formal complaints were filed (n=92). In total, 54 patients returned the questionnaire (59%; 'responders'). Of the responders, 76% reported increased symptom intensity after an FCE, ranging from 'little increase' to 'severe increase'. Symptoms of all responders returned to pre-FCE level. Duration of symptom increase of the responders ranged from 1 day to 3 weeks. Symptom increase resided to pre-FCE level within 1 week in 93% of the responders. Symptom increase was weakly related to self-reported disability (r=0.38, p <0.05). Except for gender, differences between responders and non-responders were non-significant. Conclusion: A temporary increase in symptom intensity following an FCE is common. Within the operational definitions of safety used in this study, assessment of functional capacity of patients with CLBP appears safe