Zhang Yejia, An Howard S, Tannoury Chadi, Thonar Eugene J-M A, Freedman Mitchell K, Anderson D Greg
Department of Rehabilitation Medicine, Thomas Jefferson University, Philadelphia, Pennsylvania, USA.
Am J Phys Med Rehabil. 2008 Sep;87(9):694-702. doi: 10.1097/PHM.0b013e31817c1945.
Spine care is a fast-growing sector of the outpatient practice for physiatrists. Current nonsurgical treatment modalities and surgical options for severe symptomatic intervertebral disc degeneration have limited and inconsistent clinical results. Thus, the development of novel approaches, such as biological treatments that offer the potential to halt or even reverse disc degeneration and restore physiologic disc function, are very attractive. In this article, we first review the structural changes that occur during intervertebral disc degeneration and their relationship with discogenic back pain. Subsequently, we review the treatment approaches currently under clinical trial and laboratory investigation. Physiatrists specializing in spine care have the skill set required for administering intradiscal injections and supervising a comprehensive rehabilitation program after the procedures. Ultimately, the clinical use of any biological treatment discussed herein would require the collective efforts of physicians (such as physiatrists and surgeons) and researchers (such as chemical and biomedical engineers, biologists, and chemists).
脊柱护理是物理治疗师门诊业务中一个快速发展的领域。目前针对严重症状性椎间盘退变的非手术治疗方式和手术选择，其临床效果有限且不一致。因此，开发新的方法，如生物治疗，有望阻止甚至逆转椎间盘退变并恢复椎间盘的生理功能，这极具吸引力。在本文中，我们首先回顾椎间盘退变过程中发生的结构变化及其与椎间盘源性背痛的关系。随后，我们回顾目前正在进行临床试验和实验室研究的治疗方法。专门从事脊柱护理的物理治疗师具备进行椎间盘内注射以及在术后监督综合康复计划所需的技能。最终，本文所讨论的任何生物治疗的临床应用都需要医生（如物理治疗师和外科医生）和研究人员（如化学和生物医学工程师、生物学家和化学家）的共同努力。
