Scientific basis for the treatment of low back pain.
Disc degeneration causes back pain because the function of the disc as a load transferring structure is abnormal, producing abnormal patterns of load which cause pain. Fusion has been unpredictable because it only fortuitously addresses loading. A fusion may be in such a position that it takes load from the disc, and this may be reflected in the way the fusion models, demonstrating a weight bearing pattern, but this is unpredictable. Recognition that we are dealing with a problem of load transfer allows us to design any surgical implant to solve this problem, without stopping movement.
Mulholland
R C
RC
Spinal Disorders Unit, Nottingham University Hospital, Nottingham, UK. mulhollandrcm@aol.com
D001187:Artificial Organs; D006801:Humans; D007403:Intervertebral Disc; D017116:Low Back Pain / Q000209:etiology / Q000628:therapy*; D011474:Prosthesis Design; D013122:Spinal Diseases / Q000150:complications*; D013123:Spinal Fusion / Q000379:methods; D013314:Stress, Mechanical