Article

Low back pain affects more than 80% of adults. A proportion of these adults
develops chronic low back pain (CLBP) and becomes disabled by their condition.
CLBP is expensive to diagnose and treat and in terms of associated loss of
productivity in the work place setting by affected individuals. Although
challenging, the source of CLBP can be identified. Contemporary literature
contains several studies that have established prevalence estimates for various
structural sources of CLBP. In young adults, the intervertebral disk is a common
source of CLBP, once it incurs annular injury that heals incompletely. Effective
treatment for painful disks currently is an unmet clinical need. In older adults,
the facet and sacroiliac joints are more commonly responsible for CLBP. Although
certain minimally invasive techniques do exist for these painful joints, an
effective restorative intervention has yet to be established. Annular injury
precipitates a physiologic response that can lead to a catabolic state within the
disk that impairs disk restoration. Cell loss is a feature of this process as
well as the pathophysiology associated with painful facet and sacroiliac joints.
Cellular supplementation is an attractive treatment strategy to initiate the
repair of an injured lumbosacral structure. The introduction of exogenous cells
may lead to increased extracelluar matrix production and reduced pain and
disability in diskogenic CLBP. Compelling data in animal studies have been
produced, stimulating Food and Drug Administration-regulated trials in humans.
Numerous questions remain regarding cell viability and sufficient native
nutrients to support these cells. Clinical research protocols have focused
predominantly on diskogenic CLBP, and very few have addressed painful facet
and/or sacroiliac joints.
CI - Copyright (c) 2015 American Academy of Physical Medicine and Rehabilitation.
Published by Elsevier Inc. All rights reserved.

Langue : ANGLAIS