Abstract :
The goal of this workshop was to discuss the role of biomechanics in developing strategies for the prevention and treatment of low back pain. In this context, the discussions were meant to highlight areas in which future research should be focused. Some main points which resulted from the discussions were: 1) disc degeneration is predominately a problem of middleaged males and is adversely influenced by excessive physical activity; 2) excessive physical activity may negatively influence the disc through both excessive forces and excessive motion; 3) clinical back pain is multifactoral, and confounded by psychosocial factors — consequently, direct biomechanical prediction of pain may be unrealistic. Rather, bioengineers should focus on methods to understand and predict tissue injury and degeneration; and 4) a significant component of disc degeneration is the ongoing cellular response to fluctuations in tissue stress. Based on these premises, suggestions for future research were: • • Develop improved non-invasive methods for quantifying the progression of disc degeneration.• • Conduct prospective studies to investigate how both spinal forces and spinal motion are associated with the rate of disc degeneration.• • Develop a mechanical failure criteria for disc tissues.• • Concentrate on improved validation of engineering models of the disc and development of quantitative failure criteria for the various disc tissues.• • Develop a biologic failure criteria for disc tissues.• • Conduct in vitro experimentation to elucidate how the activity of disc cells is influenced by mechanical factors.• • Integrate both mechanical and biologic failure criteria into engineering models of the disc.
The hope is that future workshop will focus on fostering research and collaborations in these priority areas.
