Low Back Pain Pathogenesis and Treatment Edited by Yoshihito Sakai pptx

LOWBACKPAIN
PATHOGENESISAND
TREATMENT
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EditedbyYoshihitoSakai
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Low Back Pain Pathogenesis and Treatment
Edited by Yoshihito Sakai


Published by InTech
Janeza Trdine 9, 51000 Rijeka, Croatia

Copyright © 2012 InTech
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First published March, 2012
Printed in Croatia

A free online edition of this book is available at www.intechopen.com
Additional hard copies can be obtained from


Low Back Pain Pathogenesis and Treatment, Edited by Yoshihito Sakai
p. cm.
ISBN 978-953-51-0338-7

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Contents
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Preface IX
Part 1 Pathogenesis 1
Chapter 1 Spinal Alignment and Low Back Pain
Indicating Spine Shape Parameters 3
Schroeder Jan and Mattes Klaus
Chapter 2 Osteophyte Formation in the Lumber
Spine and Relevance to Low Back Pain 27
Yoshihito Sakai
Chapter 3 Low Back Pain and Injury in Athletes 41
Wayne Hoskins
Chapter 4 Relationship of Duration and Intensity
of Pain with Depression and Functional
Disability Among Patients with Low-Back Pain 69
Michael O. Egwu and Afolabi O. Olakunle
Chapter 5 Psychosocial Risk Factors in the Development of LBP 79
Simone Ho
Chapter 6 Evaluation and Management of Lower
Back Pain in Oncological Patients 91
Joshua E. Schroeder, Yair Barzilay, Amir Hasharoni,
Leon Kaplan, José E. Cohen and Eyal Itshayek
Part 2 Conservative Treatment 113
Chapter 7 Pharmacotherapy for Chronic Low Back Pain 115
John H. Peniston
Chapter 8 Application of Radiofrequency

in Low Back Pain Treatment 139
Hsi-Kai Tsou and Ting-Hsien Kao
VI Contents

Part 3 Surgical Treatment 161
Chapter 9 Nonfusion Techniques for
Degenerative Lumbar Diseases Treatment 163
Leonardo Fonseca Rodrigues, Paula Voloch and Flávio Cavallari
Chapter 10 Posterior Dynamic Stabilization:
The Interspinous Spacer 189
Antoine Nachanakian, Antonios El Helou and Moussa Alaywan
Chapter 11 Development and Clinical Evaluation of
Bioactive Implant for Interbody Fusion in
the Treatment of Degenerative Lumbar Spine Disease 201
Michal Filip, Petr Linzer and Jakub Strnad
Chapter 12 Surgical Management of Low Back Pain
and Degenerative Spinal Disorders 221
Vu H. Le and S. Samuel Bederman



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Preface
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Lowbackpainisacommonpandemicdisorderwhichaffectsthelumbarspine,andis
associatedwithsubstantialmorbidityforabout80%ofthegeneralpopulationatsome
stagesduringtheirlives.Althoughlowbackpainisusuallyaself‐limitingandbenign
disorderthattrendstoimprovespontaneouslyover
time,theetiologyoflowbackpain
is generally unknown and the diagnostic label, “nonspecific low back pain”, is
frequently given when no specific pathologic process or structure can be identified.
Although low back pain resolves within a few weeks, approximately 10% of the
patientsdevelopchroniclowbackpain,which
imposeslargeburdenonsocietytothe
healthcare,andalsoabsencefromwork,andlostproductivity.Thedirectcostof low
back pain was estimated to be US$ 91 billion, and individuals with low back pain
incurred health care expenditures about 60% higher than individuals without low
backpain.
Exercise therapy is a widely used treatment for low back pain. The response to
managed care for low back pain has been emphasized on several active therapies
including rehabilitative exercise programs in physical therapy, occupational therapy,
and chiropractic therapy. Conservative treatment with exercise therapy has been
reported its effectiveness for the
 patients with low back pain; however, chronic low
back pain including degenerative spinal disease is difficult to treat because of the
range of causative mechanisms that may be involved. This difficulty leads to the
limited efficacy of current physical therapy and exemplified by the inconsistency of
existingtreatmentpatterns.Now
thatoptimalpainmanagementdemandsnotonlyon
painrelief, but alsoa beneficial effects on functionality and qualityof life,other non‐
surgical intervention such as psychosocial care, pharmacotherapy, radiofrequency
treatment,andsurgicalintervention.
This current book contains reviews and original articles with emphasis on
pathogenesisandtreatmentoflow

backpainexceptfortherehabilitativeaspectwhich
maybe carried in another volume.Consisting of three main sections,the first section
ofthebookhasafocusonpathogenesis oflowbackpain, whilethesecondand third
sections are on the treatment including conservative and surgical procedure,
respectively.
Theauthorsofeachchapterareexpertsintheirrespectivefields,andthis
X Preface

book volume is intended for all clinicians caring for the patients with low back pain,
including physicians, therapists, orthopaedic surgeons, spine surgeons, fellows and
residentsinthedisciplinesofthelumbarspinemedicine.
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YoshihitoSakai
AssistantProfessor,SpineSurgeryDepartment,
NationalCenterforGeriatricsandGerontology,
Obu,
Japan
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Part 1
Pathogenesis