Multinetwork nanobiosensing: Potential approaches in understanding, diagnosing, and tracking discogenic pain

Abstract

AbstractBackground Lower back pain associated with disc degeneration is a common and costly health condition. As a symptom, lower back pain is considered the leading cause of disability. Many studies have indicated that the intervertebral disc and supportive structures are indirectly and directly innervated, which is a factor in acute and chronic lower back pain. Unfortunately, the cellular and neural mechanisms during disc degeneration that lead to discogenic pain are not well understood. The pain caused by intervertebral disc degeneration is coined discogenic pain and is due in part to the lack of accurate diagnostic tests.Objective The long‐term objective of this preliminary study is to develop an accurate diagnostic test of a multinetwork nanobiosensing method for the objective of diagnosing discogenic pain. Within the context of the long‐term research objectives, this pilot study is aimed at providing a basic understanding of the in vivo biomechanics of human intervertebral disc with or without the degeneration process over time.Methods Medline and PubMed databases were searched from 1966 to March 2006. Studies describing the neural and cellular changes during disc degeneration were reviewed and discussed in an effort to provide a basis for understanding mechanisms of disc degeneration; however, they do not measure pain. In addition, the most current studies of diagnostic tests available today for assessing discogenic pain were also reviewed, especially those relative to the clinical association of pain with disc degeneration.Results Despite recent developments in noninvasive imaging technology, the pathophysiology of discogenic pain is poorly understood. Other than discography, there is no imaging technology that relates to this clinical problem. Currently published studies demonstrate inherent inaccuracy in the sensitivity and specificity of testing, especially for discogenic lower back pain.Conclusions There is a need to develop more reliable diagnostic tests for discogenic pain. The available literature shows that the cellular and molecular mechanisms leading to discogenic pain is largely nonexistent. The emergence of nanotechnology is opening new horizons for biosensing applications. The proposed diagnostic test should be based on in vivo measurement(s), instead of noninvasive imaging, which would capture the biochemical and biophysical mechanisms at the intervertebral disc level.Significance This project has the potential of adding a new level of understanding with a broad societal impact. From an intellectual merit standpoint, it is expected that there will be a quantum leap in our basic understanding of disc degeneration changes in vivo over time and indirectly the mechanism of discogenic pain. The societal impact standpoint will be severalfold, including the significant reduction of human suffering with increasing human productivity and quality of life. © 2008 Wiley Periodicals, Inc.