Intervertebral Disc Diseases PART 2: A Review of the Current Diagnostic and Treatment Strategies for Intervertebral Disc Disease

Int J Mol Sci. 2020 Mar 20;21(6):2135. doi: 10.3390/ijms21062135.

Abstract

With an aging population, there is a proportional increase in the prevalence of intervertebral disc diseases. Intervertebral disc diseases are the leading cause of lower back pain and disability. With a high prevalence of asymptomatic intervertebral disc diseases, there is a need for accurate diagnosis, which is key to management. A thorough understanding of the pathophysiology and clinical manifestation aids in understanding the natural history of these conditions. Recent developments in radiological and biomarker investigations have potential to provide noninvasive alternatives to the gold standard, invasive discogram. There is a large volume of literature on the management of intervertebral disc diseases, which we categorized into five headings: (a) Relief of pain by conservative management, (b) restorative treatment by molecular therapy, (c) reconstructive treatment by percutaneous intervertebral disc techniques, (d) relieving compression and replacement surgery, and (e) rigid fusion surgery. This review article aims to provide an overview on various current diagnostic and treatment options and discuss the interplay between each arms of these scientific and treatment advancements, hence providing an outlook of their potential future developments and collaborations in the management of intervertebral disc diseases.

Keywords: degenerative disc disease; gene therapy; intervertebral disc; spinal decompression; spinal endoscopy; spinal fusion; spinal injection; spinal molecular therapy; spine pain management; stem cells.

Publication types

  • Review

MeSH terms

  • Biomarkers / metabolism
  • Clinical Decision-Making
  • Conservative Treatment
  • Humans
  • Intervertebral Disc Degeneration / diagnosis*
  • Intervertebral Disc Degeneration / diagnostic imaging
  • Intervertebral Disc Degeneration / therapy*
  • Intervertebral Disc Displacement / diagnosis*
  • Intervertebral Disc Displacement / diagnostic imaging
  • Intervertebral Disc Displacement / therapy*
  • Reference Standards

Substances

  • Biomarkers

Supplementary concepts

  • Intervertebral disc disease