Engineering solutions to back pain: an interdisciplinary approach

在我们一生中的某个时候，十个人中有八个人会经历下腰痛。对一些人来说，一个疗程的止痛药和一段时间的恢复期就足以缓解症状，但情况并非总是如此，许多人继续遭受长期的疼痛和不适。在髋关节和膝关节等关节，置换手术已经变得司空见惯，并且在减轻疼痛和恢复活动方面非常成功。然而，在脊柱方面，相应的治疗仍处于起步阶段，尚未证明其长期有效性。在不到二十年的时间里，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，这似乎有些牵强。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这样的一步改变在脊柱治疗发生。通过探索基金，脊柱的计算机模型将与基础科学专家、临床医生和实业家合作开发。这些模型将用于研究新的植入材料和治疗背痛的技术。脊柱不断经历复杂的生物、生化和机械过程，如果新的治疗方法是有效的，必须考虑到这些过程。实验测试将用于单独评估这些因素，并将结果合并到计算机模型中。每个病人的脊柱结构的特性都有很大的不同，甚至每个人的背部长度也不同。这些变化也将在计算机模型中模拟，以观察一种治疗方法对一系列不同患者的效果如何。计算机模型将有助于开发和优化新的脊柱治疗方法，以便在将其引入医院之前为患者带来最大的利益。在五年的探索基金期结束时，一种新的、可靠的测试脊柱干预的方法将被开发出来，研究将开始创造一系列新的、优化的背部疼痛治疗方法。在十年的时间里，这可能会导致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.