Special Issue Introduction
|Journal of Spine & Neurosurgery (JSNS), a peer reviewed scholarly Journal, now announces it’s Upcoming Special Issue on “Lumbar Disc Herniation: Basic Science and Technological Advancements”|
Clinicians routinely encounter patients suffering from both degenerative and acute spinal pain, often as a consequence of pathology affecting the intervertebral disc (IVD). The IVD is a complex structure essential to spinal function and is subject to degenerative disease and injury. However, due to the complexity of spinal pain syndromes it is often difficult to determine the extent of the IVD’s contribution to the genesis of spinal pain. The location of the IVD is within close proximity to vital neural elements and may in the event of pathological change or injury compromise those structures.
Nonoperative management remains the foundation of initial treatment for the majority of adult patients with LDH. Approximately 80% of patients achieve a good recovery from disc herniation using nonoperative treatments. Despite this, discectomy remains an important treatment option for patients who experience persistent pain following nonoperative treatment. Discectomy treatment may have a more profound benefit in early pain management for herniation, with significant improvement in outcome measures 1 year postsurgery. Unfortunately, the advantage for surgery fades over time, with no significant differences between pain outcome measures and returnto-work rates between operative and nonoperative strategies after 4 years. Invasive treatment for painful herniation includes removing NP material and additional damage to the posterior-lateral AF altering the disc’s composition and mechanical properties. In general, removing NP material, increases disc strains and decreases the Young’s modulus in tension and compression. Significant changes in compressive mechanical function may advance the degenerative cascade in the affected joint and surrounding tissues or disc levels. Recent surgical innovations, the introduction of endoscopy and percutaneous techniques, have opened new scenarios for treating this pathology, despite long term results being overlapping in clinical and radiological terms. Contemporary new therapeutic strategies for the regeneration of the intervertebral disc have been developed. Recent clinical strategies for spine repair have moved toward maintaining disc joint mechanics through total disc arthroplasty using metal and plastic components, which have a limited life span in the body. More recently, research has focused on using tissue engineering or regenerative medicine strategies to develop biological repair strategies for injured or degenerated discs. Successful application of biological repair strategies will need to recapitulate the biochemical composition and act to distribute and absorb large complex loads similar to the healthy native joint. Tissue engineering approaches under investigation to regenerate damaged NP tissue toward healthy tissue, including cell- and material-based approaches, are the main goals of regenerative therapies.
Disc herniation and resultant disc degeneration remain significant clinical problems. Current effective strategies involve nonoperative management and surgical excision of the diseased fragment. Unfortunately, neither treatment addresses the underlying problem of disc injury and instability. Recent efforts to develop engineered tissues for partial or total disc repair and regenerative medicine strategies have resulted in promising outcomes in vitro and through small animal models. However, these strategies have significant challenges in scaling to a clinically relevant solution. Importantly, an ideal clinically relevant biological repair strategy is necessary to significantly reduce pain, restore flexibility, recapitulate the mechanical function of the healthy disc, and maintain motion of the spine.
|This Special Issue of JSNS is intended to highlight the past research studies, current aspects and future prospects of Lumbar Disc Herniation.|
|Topics for this issue include, but not limited to:|
|JSNS invites the Eminent Researcher’s, Scientist’s, Doctor’s all over the world to exchange their ideas and recent research trends through this special issue. The special issue features Original Research Articles, Reviews, Commentaries, Case Reports, Short Notes, Rapid and/ or Short Communications, letters to the editor, Case Reports, Video articles, Image articles and literature reviews.|
|Special Issue entitled "Lumbar Disc Herniation: Basic Science and Technological Advancements" has been edited by:|
|Dr. William Blake Rodgers, Spine Midwest, Inc.Jefferson City,USA|
|Dr. Alessandro Landi, University of Rome Sapienza, Italy|
|Dr. Giuseppe Maida, Anna University Hospital, Ferrara,Italy|