Engineering solutions to back pain: an interdisciplinary approach

在我们一生中的某个时候，十分之八的人会经历下腰痛。对于一些人来说，一个疗程的止痛药和一段时间的恢复期就足以缓解症状，但情况并不总是如此，许多人继续遭受长期的疼痛和不适。在髋关节和膝盖等关节，置换手术已经变得司空见惯，在减轻疼痛和恢复运动方面非常成功。然而，在脊柱方面，相应的治疗仍处于初级阶段，尚未证明其长期有效性。想象在不到20年的时间内，脊柱治疗可以发展到使用锁孔手术和其他微创技术有效治疗背痛的水平，这似乎是牵强的。然而，如果基础科学的进步以及成像和计算机建模的发展继续下去，这并不是不可能的。也许最重要的是，必须有效地利用和整合在这些许多学科中积累的理解。这项研究的目的是使脊柱治疗中的这种阶段性变化能够发生。通过探索基金，将与基础科学专家以及临床医生和实业家合作开发脊柱的计算机模型。这些模型将用于研究治疗背痛的新植入材料和治疗技术。脊柱不断经历复杂的生物、生化和机械过程，必须考虑这些过程才能使新的治疗方法有效。实验测试将被用来单独评估这些因素，并将结果合并到计算机模型中。脊柱结构的性质在不同的患者之间有很大的差异，甚至在个人的背部长度上也有很大的差异。这些变化也将在计算机模型中进行模拟，以了解对一系列不同患者的治疗效果如何。计算机模型将使新的脊柱治疗方法得以开发和优化，以便在引入医院之前为患者带来最大的好处。到探索基金的五年期结束时，一种新的可靠的脊柱干预测试方法将被开发出来，并启动研究，以创造一系列新的优化的背痛治疗方法。十年后，这可能会带来一系列新的治疗选择，到2020年，有效的微创治疗背痛可能成为现实。

At some point during our lifetimes, eight out of ten of us will experience low back pain. For some, a course of painkillers and a period of recovery will be enough to alleviate the symptoms, but this is not always the case and many people continue to suffer long term pain and discomfort. In joints such as the hip and knee, replacement surgery has become commonplace and is highly successful in reducing pain and restoring movement. In the spine however, corresponding treatments are still in their infancy and have yet to prove their long term effectiveness.It may seem farfetched to imagine that in less than two decades spinal treatments could develop to a level where back pain will be effectively treated using keyhole surgery and other minimally invasive techniques. However it is not beyond the realms of possibility if progress in the basic sciences along with developments in imaging and computer modelling continue. Perhaps most importantly, the understanding accrued in these many disciplines must be effectively harnessed and integrated. The aim of this research is to enable such a step change in spinal treatments to occur. Through the Exploration Funding, computer models of the spine will be developed in collaboration with experts from the basic sciences as well as clinicians and industrialists. These models will be used to investigate new implant materials and treatment techniques for back pain.The spine constantly undergoes complex biological, biochemical and mechanical processes which must be taken into account if new treatments are to be effective. Experimental tests will be used to assess these factors in isolation and the results combined into the computer models. There is much variation in the properties of the spinal structures both from one patient to another, and even along the length of an individual's back. These variations will also be simulated in the computer models to see how effective a treatment will be for a range of different patients. The computer models will enable new spinal treatments to be developed and optimised to bring maximum benefit to the patient before they are introduced into hospitals.By the end of the five year period of the Exploration Funding, a new and reliable method of testing spinal interventions will have been developed and research initiated to create a range of novel optimised treatments for back pain. In ten years time, this could lead to a new range of treatment options and, by 2020, effective minimally invasive treatment for back pain could become a reality.