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Degenerative Disk Disease: Stages of Degeneration, Low Back Pain, and Insights on Intradiskal Therapies

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Advanced Concepts in Lumbar Degenerative Disk Disease

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Abstract

We believe the term acquired degenerative intervertebral dysfunction (ADIVD) more accurately takes into account the histological, biomechanical, and clinical features of lumbar spine degeneration than by simply labeling these patients as having “instability.” Treatment indications are a function of the four stages of a new classification for loss of stability in the degenerative lumbar spine described here. Among available intradiskal treatments, percutaneous radiofrequency techniques can be used to treat early stage diskogenic low back pain and patients with contained disk herniation as an alternative to diskectomy. Using a “memory-coiling spiral,” nucleus pulposus implant restores normal spine kinematics and maintains disk height. The results of a multicenter European study indicate that this implant design is sound, tangible, and effective, but can only be used if the outer annulus is intact.

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Acknowledgments

The authors wish to thank Joanne Archambault and Réto Braunschweiler for the help provided during the preparation of this book chapter.

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Authors and Affiliations

  1. Department of Orthopedic Surgery, Centre Hospitalo–Universitaire Pontchaillou, Rennes, 35033, Cedex 9, France

    Jean-Louis Husson MD & Florian Cueff MD

  2. Department of Orthopedic Surgery, Centre Hospitalier de Niort, Niort, 79000, France

    Jean Lombard MD

  3. Department of Orthopedic Surgery, Centre Hospitalier Privé des Côtes d’Armor, Centre Orthopedique Briochin, Plerin, 22190, France

    Florian Cueff MD

Authors
  1. Jean-Louis Husson MD
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  2. Jean Lombard MD
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  3. Florian Cueff MD
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Corresponding author

Correspondence to Jean-Louis Husson MD .

Editor information

Editors and Affiliations

  1. Neurological and Spine Surgery, Hospital Samaritano, São Paulo, São Paulo, Brazil

    João Luiz Pinheiro-Franco

  2. Rothman Institute, Thomas Jefferson University Medical Center, Philadelphia, Pennsylvania, USA

    Alexander R. Vaccaro

  3. Cleveland Clinic Neurological Surgery, Cleveland, Ohio, USA

    Edward C. Benzel

  4. Schön Klinik München Harlaching FG Wirbelsäulenchirurgie, München, Germany

    H. Michael Mayer

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Husson, JL., Lombard, J., Cueff, F. (2016). Degenerative Disk Disease: Stages of Degeneration, Low Back Pain, and Insights on Intradiskal Therapies. In: Pinheiro-Franco, J., Vaccaro, A., Benzel, E., Mayer, H. (eds) Advanced Concepts in Lumbar Degenerative Disk Disease. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-47756-4_32

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  • DOI: https://doi.org/10.1007/978-3-662-47756-4_32

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-662-47755-7

  • Online ISBN: 978-3-662-47756-4

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