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Mechanobiology of the Intervertebral Disc and Treatments Working in Conjunction with the Human Anatomy

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Handbook of Spine Technology

Abstract

Degenerative conditions of the spine benefit from a methodical approach for the management of patients with chronic low back pain when offered surgery. Surgical solutions should consider the severity of the disease along with the approach in order to provide the patient with the best potential long-term outcomes. Posterior dynamic stabilization is considered to be an alternative therapy to rigid spinal fusion and is intended to produce equal stability within the affected vertebral space, while promoting additional mobility. Through its use in treating conditions such as spondylolisthesis, disc degeneration, and disc herniation, posterior dynamic stabilization has emerged as a potential solution to unintended consequences of more conventional therapeutic modalities, like rigid spinal fusion. Complications, such as adjacent disc disease, may be mitigated through an approach that permits additional mobility, returning the pathological segments to their intact range of movement and functionality. This chapter will review the history and development of posterior dynamic stabilization devices from their early inception to the current state of the art, as well as analyze the current pros and cons (garnered through both biomechanical and clinical testing) of each. Specifically, it will focus on the following device categories: interspinous spacers, pedicle screw and rod-based devices, and total facet replacement systems. Finally, there will be a discussion regarding the shortcomings of current metrics used to test such devices, along with an analysis on the cooperation between industry leaders and surgeons in designing said devices.

Antonio Castellvi is deceased

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Author information

Authors and Affiliations

  1. Orthopaedic Research and Education, Florida Orthopaedic Institute, Tampa, FL, USA

    Antonio Castellvi

  2. Allegheny Health Network, Department of Neurosurgery, Allegheny General Hospital, Pittsburgh, PA, USA

    Stephen Jaffee, Isaac Swink, Michele Birgelen, Alexander Yu & Boyle Cheng

  3. Department of Neurosurgery, University of Pennsylvania, Pittsburgh, PA, USA

    William Welch

  4. BioSpine, Tampa, FL, USA

    Reginald Davis

  5. Allegheny Health Network, Institute of Cellular Therapeutics, Allegheny General Hospital, Pittsburgh, PA, USA

    Brett Phillips & Nick Giannoukakis

  6. Florida Spine Institute, Clearwater, Tampa, FL, USA

    Scott Webb

Authors
  1. Stephen Jaffee
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  2. Isaac Swink
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  3. Brett Phillips
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  4. Michele Birgelen
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  5. Alexander Yu
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  6. Nick Giannoukakis
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  7. Boyle Cheng
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  8. Scott Webb
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  9. Reginald Davis
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  10. William Welch
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  11. Antonio Castellvi
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Corresponding author

Correspondence to Stephen Jaffee .

Editor information

Editors and Affiliations

  1. Department of Neurosurgery, Allegheny General Hospital Department of Neurosurgery, Mars, PA, USA

    Boyle Cheng

Section Editor information

  1. Departments of Bioengineering and Orthopaedic Surgery, Colleges of Engineering and Medicine, University of Toledo, Toledo, OH, USA

    Vijay Goel

  2. Industrial and Systems Engineering, Auburn University, Auburn, AL, USA

    Chip Wade

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Jaffee, S. et al. (2021). Mechanobiology of the Intervertebral Disc and Treatments Working in Conjunction with the Human Anatomy. In: Cheng, B. (eds) Handbook of Spine Technology. Springer, Cham. https://doi.org/10.1007/978-3-319-33037-2_22-1

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  • DOI: https://doi.org/10.1007/978-3-319-33037-2_22-1

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-33037-2

  • Online ISBN: 978-3-319-33037-2

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