INVESTIGATIONS ON THE REGULATION OF INTERVERTEBRAL DISC CELL MATRIX METALLOPROTEINASES
Funder
National Health and Medical Research Council
Funding Amount
$331,320.00
Summary
Degeneration of the intervertebral disc is a painful disabling condition with major socioeconomic consequences. Medical problems associated with disc degeneration and back-pain, of sufficient severity to warrant consultation with a physician, are experienced by 90% of the population some time during their lives. In man, back pain increases in incidence in the third and fourth decades of life, peaks in the fifties and declines thereafter. Changes in population demographics indicate this problem w ....Degeneration of the intervertebral disc is a painful disabling condition with major socioeconomic consequences. Medical problems associated with disc degeneration and back-pain, of sufficient severity to warrant consultation with a physician, are experienced by 90% of the population some time during their lives. In man, back pain increases in incidence in the third and fourth decades of life, peaks in the fifties and declines thereafter. Changes in population demographics indicate this problem will increase in severity over the next few decades. American Bureau of Census data indicate that between 1990 to 2010 the number of people >45 years will increase from 82 to 124 million, the number of elderly in emerging countries will also increase between 200 to 400% in the next 30 years. In the United States, back-pain is the second most common reason that people visit a physician and medical conditions related to back-pain account for more hospitalisations than any other musculoskeletal disorder. Despite its high incidence, associated problems of incapacity and economic implications, costed at $100 million per annum in Australia in 1992, and US$100 billion globally in 1999-2000 (Dorland Data Networks, PA, USA) the causes of low back-pain are still poorly understood. Disc disease is responsible for 23-40% of all cases of low back-pain. The management of discogenic low back-pain is currently empirical, directed either toward life-style changes to minimise symptomatology or to surgical resection or spinal arthrodesis to restrict articulation. Based on our recent findings and those of colleagues over the last 16 years, it is our strong conviction that it should be possible with a better understanding of disease mechanisms and with the use of modern technologies to inhibit, reverse or ideally prevent disc degeneration. Without such basic research there will be no scientific foundation upon which prospective therapies may be based.Read moreRead less
Interrelationships Between The Disc And Bone Of Lumbar Spinal Segments
Funder
National Health and Medical Research Council
Funding Amount
$423,625.00
Summary
The cause of back pain due to osteoarthritis, osteoporotic vertebral crush fracture, and ageing is poorly understood. Vertebral deformity, intervertebral disc disorganisation, and change to vertebral bone structure are features associated with degeneration of the spine and with back pain. Degenerative disc disease is one of the major causes of back symptoms and is believed to be associated with degeneration of the spine. Spinal degeneration includes disc degeneration, facet joint osteoarthritis, ....The cause of back pain due to osteoarthritis, osteoporotic vertebral crush fracture, and ageing is poorly understood. Vertebral deformity, intervertebral disc disorganisation, and change to vertebral bone structure are features associated with degeneration of the spine and with back pain. Degenerative disc disease is one of the major causes of back symptoms and is believed to be associated with degeneration of the spine. Spinal degeneration includes disc degeneration, facet joint osteoarthritis, compromised vertebral body bone quality, muscle and ligament alterations. It is assumed that these changes result in increased or abnormal spine motion and modified load distribution across the spinal joint. It has been found that with age, there is increased disorganisation of the intervertebral disc and decreased quality of vertebral cancellous bone. However, bones with the same density within the range of normal subjects, can show selective loss of bone structure and reduced load-bearing capacities of these vertebrae. An important concept here is that even for a given bone mass, fracture risk increases with age, supporting the view that there is a component of bone fragility that is independent of mass. Increased bone fragility may be associated with compromised cancellous bone structure. While the relationship between disc degeneration and changes in vertebral bone is commonly invoked, the mechanisms of this relationship have largely been overlooked, with age changes given more attention. However, it may be that intervertebral disc disorganisation modulates age-related bone changes within the spine. Disc degeneration may influence trabecular bone responses before changes with age put the patient at risk of vertebral crush fracture. We propose that the mature disc cannot effectively regenerate after damage, and thus responses to disc damage will be more readily observed in vertebral bone architecture than in the disc.Read moreRead less
Immediate Cooling And Emergency Decompression (ICED) For The Treatment Of Spinal Cord Injury: Pilot, Safety And Feasibility Studies
Funder
National Health and Medical Research Council
Funding Amount
$600,008.00
Summary
Victims of Spinal Cord Injury are young, have severe paralysis, complex needs and high lifetime costs. Although urgent surgery greatly improves outcome, it is difficult to achieve because of logistical difficulties. To expand the time window for early surgery, it is proposed to immediately cool patients. This project will conduct the pilot studies necessary before commencing a clinical trial of immediate cooling and emergency decompression (ICED) in patients with cervical spinal cord injuries.
Therapeutic Development Of A Novel EphA4 Antagonist For Spinal Cord Injuries
Funder
National Health and Medical Research Council
Funding Amount
$687,105.00
Summary
Spinal cord injuries impose a significant burden on patients and their carers. At present, there are no treatments for spinal cord injury that provide functional improvement. This research program will develop a novel therapeutic molecule, EphA4-Fc, which promotes axonal regeneration and delivers significant functional improvement. We will determine the most effective protocol for EphA4-Fc administration and the physiological and functional outcomes of these treatment regimes.
ENDOGENOUS PAIN RELIEF IN HEALTHY AND OSTEOARTHRITIC PATIENTS
Funder
National Health and Medical Research Council
Funding Amount
$509,926.00
Summary
Pain has a detrimental impact on ones quality of life and a significant financial impact on the community. Given this, there is a substantial effort aimed at developing pain relieving compounds. One way in which our own brain can provide complete pain relief is via a mechanism called diffuse noxious inhibitory control. We currently do not know how this mechanism works and the aim of this investigation is to explore this mechanism in healthy and osteoarthritis patients use human brain imaging.
Anterior Cruciate Ligament Reconstruction (ACLR) And Neuromuscular Training
Funder
National Health and Medical Research Council
Funding Amount
$99,248.00
Summary
Anterior Cruciate Ligament Reconstructive (ACLR) following ACL rupture is a successful surgery that improves stability of the knee joint. However, evidence is emerging that despite undergoing reconstructive surgery, osteoarthritis of the knee joint is prevalent in the proceeding years. The proposed research aims to improve biomechanical abnormalities by providing a neuromuscular intervention. This could lead to a more optimal biomechanical pattern which could reduce the degenerative changes occu ....Anterior Cruciate Ligament Reconstructive (ACLR) following ACL rupture is a successful surgery that improves stability of the knee joint. However, evidence is emerging that despite undergoing reconstructive surgery, osteoarthritis of the knee joint is prevalent in the proceeding years. The proposed research aims to improve biomechanical abnormalities by providing a neuromuscular intervention. This could lead to a more optimal biomechanical pattern which could reduce the degenerative changes occurring within the knee of ACLR patients.Read moreRead less
This research program aims to utilise three new clinical trials to treat pain from osteoarthritis of the knee and hand. These treatments use existing medications, but for new indications. This project will determine if these treatments reduce pain and slow structural changes over two years of treatment. It also has the potential to develop the first treatment for osteoarthritis which changes the natural course of the disease rather than merely treating symptoms.
Does Low Dose Amitriptyline Reduce Pain In Knee Osteoarthritis? A Double Blind, Randomised, Pragmatic, Placebo Controlled Clinical Trial Of Amitriptyline In Addition To Usual Care
Funder
National Health and Medical Research Council
Funding Amount
$413,704.00
Summary
Pain is the main problem for people with osteoarthritis, a common form of arthritis. This pain is not controlled well. Pain comes from structural changes in the joint. However, after time, some people develop pain due to changes in the nervous system, called pain sensitisation. This is not affected by usual treatments. Amitriptyline is used to treat pain sensitisation. This study is a randomised trial to see whether amitriptyline, relieves pain in people with knee osteoarthritis over 3 months.
Unravelling The Riddle Of Spondylolysis: A Novel Biomechanical Approach Incorporating Innovative Strain Field Mapping, Acute Fracture Path Mapping And In Vivo Weightbearing Spinal Kinematics Derived From Open Magnetic Resonance Imaging.
Funder
National Health and Medical Research Council
Funding Amount
$334,673.00
Summary
Low back pain represents a significant social and economic burden in Australia and can be debilitating for individuals. This project aims to understand the biomechanical origins and consequences of spondylolysis, a common spinal stress fracture affecting both children and adults. The results of these studies will contribute to improved prevention, detection and treatment of this spinal condition, and reduce the incidence of more serious spinal problems which can occur subsequent to spondylolysis ....Low back pain represents a significant social and economic burden in Australia and can be debilitating for individuals. This project aims to understand the biomechanical origins and consequences of spondylolysis, a common spinal stress fracture affecting both children and adults. The results of these studies will contribute to improved prevention, detection and treatment of this spinal condition, and reduce the incidence of more serious spinal problems which can occur subsequent to spondylolysis.Read moreRead less
The Next Generation Of Biomaterials; In Vivo Assessment Of Lumbar Spinal Fusion Biodegradable Interbody Cages
Funder
National Health and Medical Research Council
Funding Amount
$85,932.00
Summary
Back pain represents one of the major health and economic problems facing the western world. Surgery is an inevitable outcome for many sufferers and involves the implantation of metallic rods screws, plates or cages. Biodegradable implants have theoretical advantages, but until now no material has existed that can sustain he rigours of implantation into a load bearing site. We have developed such a material which will lead to improvements in the treatment of many orthopaedic conditions.