Use of Temporary Implantable Biomaterials to Reduce Leg Pain and Back Pain in Patients with Sciatica and Lumbar Disc HerniationReportar como inadecuado


Use of Temporary Implantable Biomaterials to Reduce Leg Pain and Back Pain in Patients with Sciatica and Lumbar Disc Herniation


Use of Temporary Implantable Biomaterials to Reduce Leg Pain and Back Pain in Patients with Sciatica and Lumbar Disc Herniation - Descarga este documento en PDF. Documentación en PDF para descargar gratis. Disponible también para leer online.

1

Keck School of Medicine at University of Southern California - 1321 N. Mission Road, Los Angeles, CA 90033, USA

2

FzioMed, Inc. - 231 Bonetti Drive, San Luis Obispo, CA 90033, USA





*

Author to whom correspondence should be addressed.



Abstract The principle etiology of leg pain sciatica from lumbar disc herniation is mechanical compression of the nerve root. Sciatica is reduced by decompression of the herniated disc, i.e., removing mechanical compression of the nerve root. Decompression surgery typically reduces sciatica more than lumbar back pain LBP. Decompression surgery reduces mechanical compression of the nerve root. However, decompression surgery does not directly reduce sensitization of the sensory nerves in the epidural space and disc. In addition, sensory nerves in the annulus fibrosus and epidural space are not protected from topical interaction with pain mediators induced by decompression surgery. The secondary etiology of sciatica from lumbar disc herniation is sensitization of the nerve root. Sensitization of the nerve root results from a mechanical compression, b exposure to cellular pain mediators, and-or c exposure to biochemical pain mediators. Although decompression surgery reduces nerve root compression, sensory nerve sensitization often persists. These observations are consistent with continued exposure of tissue in the epidural space, including the nerve root, to increased cellular and biochemical pain mediators following surgery. A potential contributor to lumbar back pain LBP is stimulation of sensory nerves in the annulus fibrosus by a cellular pain mediators and-or b biochemical pain mediators that accompany annular tears or disruption. Sensory fibers located in the outer one-third of the annulus fibrosus increase in number and depth as a result of disc herniation. The nucleus pulposus is comprised of material that can produce an autoimmune stimulation of the sensory nerves located in the annulus and epidural space leading to LBP. The sensory nerves of the annulus fibrosus and epidural space may be sensitized by topical exposure to cellular and biochemical pain mediators induced by lumbar surgery. Annulotomy or annular rupture allows the nucleus pulposus topical access to sensory nerve fibers, thereby leading to LBP. Coverage of the annulus and adjacent structures in the epidural space by absorbable viscoelastic gels appears to reduce LBP following surgery by protecting sensory fibers from cellular and biochemical pain mediators. View Full-Text

Keywords: biomaterial; viscoelastic gel; back pain; sciatica; lumbar surgery; fibrosis; cytokines; disc herniation; oxiplex; healon biomaterial; viscoelastic gel; back pain; sciatica; lumbar surgery; fibrosis; cytokines; disc herniation; oxiplex; healon





Autor: Gere S. DiZerega 1,* , Melissa M. Traylor 2, Lisa S. Alphonso 2 and Samuel J. Falcone 2

Fuente: http://mdpi.com/



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