TY  - CHAP
M1  - Book, Section
TI  - Intradiscal Biacuplasty
A1  - Yelle, Mark
A1  - Kapural, Leonardo
A2  - Diwan, Sudhir
A2  - Staats, Peter S.
Y1  - 2015
N1  - 
T2  - Atlas of Pain Medicine Procedures
AB  - Approximately  45%  of  back  pain  can  be  attributed  to  discogenic  source.1,2  Lumbar  discogenic  pain  is  typically  caused  by  pathophysiological  changes  that  occur  within  the  intervertebral  disc.  A  loss  of  hydration  in  the  nucleus  pulposus  from  aging,  chronic  abnormal  posturing,  or  injury  can  lead  to  both,  delamination  and  fissuring  in  the  annulus  fibrosus  (Figure  36-1A,  B).  This  structural  damage  is  a  part  of  unclear  degenerative  process,  where  in  addition  to  described  changes,  there  is  an  in-growth  of  the  nerve  endings  (nociceptors)  that  are  normally  restricted  to  the  outer  third  of  the  annulus,  extending  now  to  the  nucleus  of  the  affected  disc.  Inflammatory  cytokines  such  as  tumor  necrosis  factor,  nitric  oxide  and  metalloproteinases,  are  also  released,  causing  pain  through  several  possible  mechanisms.  These  changes  transform  the  disc  into  a  primary  nociceptive  structure.  In  addition,  structural  changes  intrinsic  to  the  intervertebral  disc  can  lead  to  reduced  mechanical  load-bearing  capacity  resulting  in  altered  spinal  biomechanics,  which  can  contribute  to  future  back  pain.  
SN  - 
PB  - McGraw-Hill Education
CY  - New York, NY
Y2  - 2024/04/19
UR  - accessanesthesiology.mhmedical.com/content.aspx?aid=1107197707
ER  -