Investigating Intervertebral Disc Endplate Degeneration for Non-Specific Low Back Pain

Project Description Narrative:

Chronic low back pain and its treatment is a major health problem associated with high costs, marginal outcomes, and significant psychosocial and economic consequences. Low back pain is a prevalent problem in the U.S., with 39% of adults nationally reporting low back pain in 2019, according to the Centers for Disease Control and Prevention. It is estimated that low back pain costs the nation $100 billion annually, which includes healthcare expenses, lost productivity, and wages.

Most chronic low back pain is associated with degeneration of the discs between the vertebral bones, which act as a cushion for the spinal column. Numerous studies have indicated that degenerating discs in the spine lose their cushioning properties and apply uneven pressures on the vertebral bone adjacent to it during daily physical activities. A thin layer of tissue between the disc and vertebral bone is called the endplate. Histology studies have demonstrated that these endplates undergo structural damage and inflammation with ongoing trauma, eventually triggering the growth of new blood vessels and nerves in this area. As a result, endplates become sensitized, and patients feel pain when the degenerating disc applies pressure.

Currently, there is no established diagnostic method for the assessment of such vertebral endplate damage. There is an urgent need for more accurate diagnostic techniques for this widespread health problem. However, there are currently no valid imaging criteria for understanding the pathology of non-specific low back pain or predicting treatment outcomes. The goal of this project is to address this shortcoming.