Emerging Technologies for Degenerative Disk Disease: Potential Synergy Between Biochemical Signaling and Spinal Biomechanics

Interventional spinal procedures are performed with increasing frequency, and they remain an important tool for physiatrists treating patients with spine pain. As the potential treatment options expand with novel technologies on the horizon, such as gene- and cell-based therapies, the physiatrist will be uniquely poised to deliver such treatments in conjunction with exercise-based therapies. Therefore, the development of novel technologies requires particular attention to the potential synergy between biochemical signaling and spinal biomechanics. It is hoped that such insight will result in improved treatment options for patients with pain related to degenerative disk disease, leading to improved nonoperative outcomes. This article reviews the current knowledge of precipitants of disk degeneration, the effects of beneficial and traumatic levels of disk loading, and how each of these can be impacted by novel treatment options.