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Review

Discogenic Low Back Pain: Anatomic and Pathophysiologic Characterization, Clinical Evaluation, Biomarkers, AI, and Treatment Options

by
Matteo De Simone
1,2,3,*,
Anis Choucha
4,5,
Elena Ciaglia
1,
Valeria Conti
1,6,
Giuseppina Pecoraro
2,
Alessandro Santurro
1,2,7,
Annibale Alessandro Puca
1,
Marco Cascella
1,* and
Giorgio Iaconetta
1,3
1
Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, University of Salerno, Via S. Allende, 84081 Baronissi, Italy
2
BrainLab S.R.L., Mercato San Severino, 84085 Salerno, Italy
3
Neurosurgery Unit, University Hospital “San Giovanni di Dio e Ruggi, D’Aragona”, 84131 Salerno, Italy
4
Department of Neurosurgery, Aix Marseille University, APHM, UH Timone, 13005 Marseille, France
5
Laboratory of Biomechanics and Application, UMRT24, Gustave Eiffel University, Aix Marseille University, 13005 Marseille, France
6
Clinical Pharmacology Unit, University Hospital “San Giovanni di Dio e Ruggi, D’Aragona”, 84131 Salerno, Italy
7
Legal Medicine Unit, University Hospital “San Giovanni di Dio e Ruggi, D’Aragona”, 84131 Salerno, Italy
*
Authors to whom correspondence should be addressed.
J. Clin. Med. 2024, 13(19), 5915; https://doi.org/10.3390/jcm13195915
Submission received: 4 September 2024 / Revised: 24 September 2024 / Accepted: 2 October 2024 / Published: 3 October 2024
(This article belongs to the Special Issue Clinical Advances in Orthopaedic Treatment of Lumbar and Spine Diseases)
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Abstract

Discogenic low back pain (LBP) is a significant clinical condition arising from degeneration of the intervertebral disc, a common yet complex cause of chronic pain, defined by fissuring in the annulus fibrosus resulting in vascularization of growing granulation tissue and growth of nociceptive nerve fibers along the laceration area. This paper delves into the anatomical and pathophysiological underpinnings of discogenic LBP, emphasizing the role of intervertebral disc degeneration in the onset of pain. The pathogenesis is multifactorial, involving processes like mitochondrial dysfunction, accumulation of advanced glycation end products, and pyroptosis, all contributing to disc degeneration and subsequent pain. Despite its prevalence, diagnosing discogenic LBP is challenging due to the overlapping symptoms with other forms of LBP and the absence of definitive diagnostic criteria. Current diagnostic approaches include clinical evaluations, imaging techniques, and the exploration of potential biomarkers. Treatment strategies range from conservative management, such as physical therapy and pharmacological interventions, to more invasive procedures such as spinal injections and surgery. Emerging therapies targeting molecular pathways involved in disc degeneration are under investigation and hold potential for future clinical application. This paper highlights the necessity of a multidisciplinary approach combining clinical, imaging, and molecular data to enhance the accuracy of diagnosis and the effectiveness of treatment for discogenic LBP, ultimately aiming to improve patient outcomes.
Keywords: LBP; low back pain; pathophysiology; clinical trajectory; biomarkers; treatment; AI; pain matrix; discogenic LBP LBP; low back pain; pathophysiology; clinical trajectory; biomarkers; treatment; AI; pain matrix; discogenic LBP

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MDPI and ACS Style

De Simone, M.; Choucha, A.; Ciaglia, E.; Conti, V.; Pecoraro, G.; Santurro, A.; Puca, A.A.; Cascella, M.; Iaconetta, G. Discogenic Low Back Pain: Anatomic and Pathophysiologic Characterization, Clinical Evaluation, Biomarkers, AI, and Treatment Options. J. Clin. Med. 2024, 13, 5915. https://doi.org/10.3390/jcm13195915

AMA Style

De Simone M, Choucha A, Ciaglia E, Conti V, Pecoraro G, Santurro A, Puca AA, Cascella M, Iaconetta G. Discogenic Low Back Pain: Anatomic and Pathophysiologic Characterization, Clinical Evaluation, Biomarkers, AI, and Treatment Options. Journal of Clinical Medicine. 2024; 13(19):5915. https://doi.org/10.3390/jcm13195915

Chicago/Turabian Style

De Simone, Matteo, Anis Choucha, Elena Ciaglia, Valeria Conti, Giuseppina Pecoraro, Alessandro Santurro, Annibale Alessandro Puca, Marco Cascella, and Giorgio Iaconetta. 2024. "Discogenic Low Back Pain: Anatomic and Pathophysiologic Characterization, Clinical Evaluation, Biomarkers, AI, and Treatment Options" Journal of Clinical Medicine 13, no. 19: 5915. https://doi.org/10.3390/jcm13195915

APA Style

De Simone, M., Choucha, A., Ciaglia, E., Conti, V., Pecoraro, G., Santurro, A., Puca, A. A., Cascella, M., & Iaconetta, G. (2024). Discogenic Low Back Pain: Anatomic and Pathophysiologic Characterization, Clinical Evaluation, Biomarkers, AI, and Treatment Options. Journal of Clinical Medicine, 13(19), 5915. https://doi.org/10.3390/jcm13195915

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