Health Scan: Synthetic spinal discs fight back pain

Damaged spinal discs cause a great deal of trouble for people with chronic back problems, and a burden on the economy due to absenteeism from work and financial costs of treatment.

Sufferers are told to rest, take analgesics and – if these don’t help – undergo operations, but these are not always fully effective. One-tenth of people suffering from degenerated discs suffer from longterm pain and disability.

But some scientists are trying to find ways to alleviate the problem of damaged discs. Dr. Sarit Sivan of the Technion- Israel Institute of Technology’s biomedical faculty is one of the three winners of the European Commission’s new Marie Curie Prize for outstanding achievement in spinal disc research, announced today at a ceremony in Nicosia, Cyprus. She won the prize in the “Innovation and Entrepreneurship” category.

Sivan was selected for her work on materials that can restore the biomechanical function of degenerated discs in spinal columns. Disc degeneration caused by the gradual loss of some of their main components, mainly due to aging, leads to a decrease in biomechanical function affecting the spine. During her Marie Curie fellowship at the University of Oxford in the UK, Sivan developed and successfully tested biocompatible gel-like materials that could replace, through a non-invasive injection, the lost disc components and mimic their functioning.

Spinal discs are made of collagen, water and proteins called proteoglycans; when the discs begin to degenerate, the amounts of proteoglycans and water decline and the damaged disc moves down lower, causing it to rub against others. This makes blood vessels and nerves enter the collagen, resulting in pain that increases as the disc becomes more diseased. A biological approach to fixing discs faced problems because calcification of the disc makes it difficult for collagen cells to survive, which results in the blockage of access of nutrients to the cells and the removal of waste.

A potential solution, suggested Sivan, would be rigid, synthetic discs with properties similar to natural ones. However, inserting them by cutting the collagen ring that binds to the spine can lead to the disc’s expulsion due to body weight.

Sivan developed synthetic injectable material that overcomes this problem and can cope with weight the same way natural tissue does.

The judges’ panel praised Sivan’s scientific expertise, innovation, entrepreneurial approach and her ability to exploit basic science findings commercially. She developed multiple innovations, has an impressive number of patents and contributed to the creation of a company currently running clinical trials on related research.

The other two winners were Dr. Gkikas Magiorkinis from Greece, in the “Promising Research Talent” category, honored for his work on tracing how the Hepatitis C virus has spread around the world, and Dr Claire Belcher from the UK for “Communicating Science,” for her study of the Earth’s geological past and its impact on plant and animal life – a subject she has brought to wider attention through regular appearances on TV and in other media.

RANDOM HEALTH SCREENING AND MORTALITY

Carrying out general health checks does not reduce deaths overall or from serious diseases like cancer and heart disease, according to researchers at the Cochrane Library, a collection of independent databases in medicine and other healthcare specialties that summarize and interpret the results of medical research.

In some countries, general health checks are offered as part of standard practice with the aim of reducing deaths and ill health by enabling early detection and treatment of disease. However, there are potential negative implications – for example, diagnosis and treatment of conditions that might never have led to any symptoms of disease or shortened life.

The researchers based their findings on 14 trials involving 182,880 people. In nine of them, with a total of 11,940 deaths, the researchers found no difference between the number of deaths in the two groups (those who had undergone health checks and those who hadn’t) in the long term, either overall or specifically due to cancer or heart disease.

Other outcomes were poorly studied, but suggested that offering general health checks has no impact on hospital admissions, disability, worry, specialist referrals, additional visits to doctors or time off work.

“From the evidence we’ve seen, inviting patients to general health checks is unlikely to be beneficial,” said lead researcher Lasse Krogsbøll of the Nordic Cochrane Center in Copenhagen.

“One reason for this might be that doctors identify additional problems and take action when they see patients for other reasons.”

“What we’re not saying is that doctors should stop carrying out tests or offering treatment when they suspect there may be a problem. But we do think that public healthcare initiatives that are systematically offering general health checks should be resisted.”

According to the review, new studies should be focused on the individual components of health checks and better targeting of conditions such as kidney disease and diabetes. They should be designed to further explore the harmful effects of general health checks, which are often ignored, producing misleading conclusions about the balance of benefits and harm. Another problem is that those people who attend health checks when invited may be different from those who do not. People who are at a high risk of serious illness may be less likely to attend.

Asked to comment, Prof. Manfred Green, dean of the School of Public Health at the University of Haifa, said, “The paper is very interesting and actually corroborates a lot of what some of us in public health have been saying for a long time. The findings also match much of the substance in the recommendations of the American Task Force for Preventive Services. Basically they say that ‘random’ regular general check-ups have little value, unless they are strictly targeted toward procedures that have reasonable evidence of efficacy.”