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Axial Back Pain: Treatment Options and Supporting Clinical Evidence
Keyword(s)
CA, Aesculap, 1374, nurse, CCM, nurse, allied, axial, back, low back, trauma, degenerative disc disease, disability, spine, spinal disorder, intervertebral disc dehydrates, pressure increase, fusion, chronic pain, arthrodesis, arthroplasty, surgeries, disc replacement, treatment, clinical evidence, axial back pain, lumbar spine, intervertebral disc anatomy, back pain, lumbar arthrodesis, lumbar arthroplasty,
Credits
CA:2.0, NCCT:2.0
Description
At some point in life, low back pain affects the majority of the population and is a leading cause of
disability worldwide. Excluding pain related to trauma, degenerative disc disease (DDD) is the most
common spinal disorder. When the nucleus of the intervertebral disc dehydrates and can no longer
cushion the two vertebrae, pressure increases on the spinal cord causing neurological impairment.
This can lead to chronic pain in the lower back that requires surgical intervention through
arthrodesis (fusion) or arthroplasty (total disc replacement). Although over 200,000 fusion surgeries
are performed annually, a subset of this patient population may be candidates for total disc
replacement. Therefore, it is important that nurses and case managers are familiar with DDD and
the treatment options available today. This continuing education activity will review surgical
treatment options for axial pain caused by DDD and new clinical evidence that assists spine
surgeons in selecting the most effective treatment plan for appropriately indicated patients. It will
provide an overview of the prevalence of axial back pain and DDD, followed by brief discussions of
the relevant lumbar spine and intervertebral disc anatomy and the clinical implications of DDD.
Conservative and surgical treatment options will be reviewed, with a focus on lumbar arthrodesis
and lumbar arthroplasty. Key clinical evidence for each of the surgical treatment options will be
summarized.