Mechanical Biomarkers of Chronic Low Back Pain

摘要 在正常脊柱功能期间和何时，椎间盘(IVD)在转移负荷方面起着至关重要的作用 这种正常的功能丧失，可能会出现症状、退变和脊柱力学改变。整体而言 这项工作的科学前提是，对来自 导致慢性下腰痛(LBP)的机械、炎症和生物心理社会因素。一个重要的 GAP对IVD退变与LBP之间的关系认识较差。这种缺乏理解 导致成像和自我报告的疼痛之间的不一致，最终，由 排他性程序。为了解决这一差距，我们将使用创新的活体成像工具来量化 IVD的机械功能。我们还将测量定量的感觉因素，生化标记物，以及 生物、心理和社会因素，当与机械功能相结合时，可能更好地识别亚群或 LBP的表型。该项目的总体目标是确定IVD的机械功能是否是潜在的 危险因素以及机械功能是否有助于确定LBP的表型。由此得出的结论是 研究将导致进行纵向分析，以确定这些表型是否预测从 急性到慢性LBP。这项拟议研究的基本原理是：1)改变了IVD的机械功能 为LBP做出贡献。2)LBP是一种异质性疾病，可由机械、 炎性和中枢性疼痛来源。中心假设是在体内测量的IVD机械性 功能将是急性和慢性非特异性LBP的重要潜在风险因素，这 措施将改善LBP的表型。在目标I中，我们将量化体内与 急性和慢性非特异性LBP患者和无症状患者的IVD机械功能测定 控制。在AIM II中，我们将使用潜在风险因素的组合得出明确定义的LBP表型。 识别LBP的表型将允许特定的康复、外科手术、药物或行为 有针对性的治疗，从而改善患者的预后。

Abstract The intervertebral disc (IVD) has an essential role in transferring load during normal spine function and when this normal function fails, symptoms, degeneration and altered spine mechanics may occur. The overall scientific premise of this work is that there is a gap in knowledge of the relationship between contributions from mechanical, inflammatory and biopsychosocial factors that lead to chronic low back pain (LBP). An important gap is a poor understanding of the relationship between IVD degeneration and LBP. This lack of understanding leads to discordance between imaging and self-reported pain and, ultimately, treatments being delivered by an exclusionary process. To address this gap, we will use innovative in vivo imaging tools to quantify the mechanical function of the IVD. We will also measure quantitative sensory factors, biochemical markers, and biopsychosocial factors that, when combined with mechanical function, may better identify subgroups or phenotypes of LBP. The overall goal of this project is to identify if mechanical function of the IVD is a potential risk factor and whether mechanical function can assist with defining phenotypes of LBP. The findings from this study would lead to longitudinal analyses to determine whether these phenotypes predict the transition from acute to chronic LBP. The rationale for this proposed research is that: 1) altered mechanical function of the IVD contributes to LBP. 2) LBP is a heterogeneous condition that can result from a combination of mechanical, inflammatory, and central pain based sources. The central hypothesis is that in vivo measured IVD mechanical function will be an important potential risk factor for both acute and chronic non-specific LBP and that this measure will improve the phenotyping of LBP. In Aim I, we will quantify the association between in-vivo measured IVD mechanical function among acute and chronic non-specific LBP participants and asymptomatic controls. In Aim II, we will derive well-defined phenotypes of LBP using combinations of potential risk factors. Identifying phenotypes of LBP will allow for specific rehabilitation, surgical, pharmaceutical or behavioral treatments to be targeted, resulting in improved patient outcomes.