Time varying modulators of spine injury mechanics and material properties of the intervertebral disc

世界卫生组织将腰痛列为全球三大职业健康问题之一。80%的人在一生中的某个时候都会遭受腰痛的折磨，这使得腰痛成为影响加拿大普通人群的最普遍和最昂贵的肌肉骨骼问题。有证据表明，腰痛的主要原因是与日常活动和工业任务相关的机械暴露。本研究计划的总体目标是确定每日负荷暴露在腰背部组织损伤和疼痛产生中的作用。与重复暴露相关的脊柱结构（如椎间盘）损伤的发生和进展的原因将被调查。对椎间盘的材料特性和与机械负荷相关的损伤机制有一个深入的了解是至关重要的，因为椎间盘的生物修复机制由于该结构缺乏血液供应而缓慢。一旦椎间盘损伤的第一阶段发生，脊髓组织自我修复的能力很容易被损伤恶化所超越。这项研究的结果将提供与时间相关的组织材料特性，这是目前无法获得的，也是理解和建模椎间和腰背部损伤的限制因素。最终，将累积或重复暴露与潜在的疼痛产生联系起来，将对开发评估每日负荷和设置阈值限制或暴露标准以防止伤害的方法做出有力贡献。

Globally, the World Health Organization has deemed low back pain one of the top three occupational health problems. Eighty percent of the population will suffer from low back pain at some point in their life making low back pain the most prevalent and costly musculoskeletal problem affecting the general population of Canada. Evidence suggests that the primary cause of low back pain is through mechanical exposure associated with everyday activities and industrial tasks. The overall objective of this research program is to determine the role of daily loading exposures in the generation of low back tissue damage and pain. The causes of injury initiation and progression in the structures of the spine (e.g. the intervertebral disc), associated with repetitive exposure will be investigated. It is critical to develop a solid understanding of the material properties of the intervertebral disc and the injury mechanisms associated with mechanical loading, as the biological repair mechanisms in the intervertebral disc are slow due to the lack of blood supply to this structure. The ability of the spinal tissues to repair themselves can be easily outpaced by injury deterioration once the first stage of an injury to the intervertebral disc has occurred. The outcomes from this research will provide time dependent tissue material properties that are currently unavailable and are a limiting factor in the understanding and modeling of the intervertebral and low back injuries. Ultimately, the linking of cumulative or repetitive exposure to potential pain generation would be a powerful contribution in developing methods to assess daily loading and set threshold limits or exposure standards to prevent injuries.