Γιατροί και μηχανικοί στη Βρετανία ανέπτυξαν μία πολύ λεπτή -με πλάτος ανθρώπινης τρίχας- και φουσκωτή συσκευή, που εμφυτεύεται στη σπονδυλική στήλη και βοηθά στη θεραπεία των σοβαρών πόνων.
Η συσκευή, την οποία δημιούργησαν ερευνητές του Πανεπιστημίου του Κέιμπριτζ, που έκαναν τη σχετική δημοσίευση στο περιοδικό «Science Advances», μπορεί να τυλιχθεί μέσα σε έναν μικροσκοπικό κύλινδρο, να τοποθετηθεί σε μία βελόνα και να εμφυτευθεί στη σπονδυλική στήλη (στην περιοχή όπου γίνονται οι επισκληρίδιες ενέσεις για να ελεγχθούν οι πόνοι του τοκετού), χωρίς να χρειαστεί επεμβατική διαδικασία.
Πώς λειτουργεί το εμφύτευμαΌταν βρεθεί μέσα στο σώμα, η συσκευή φουσκώνει με νερό ή αέρα και ξετυλίγεται σαν ένα μικρό στρώμα που καλύπτει ένα μεγάλο τμήμα του νωτιαίου μυελού. Όταν συνδέεται με μία γεννήτρια παλμών, τα ηλεκτρόδια της συσκευής αρχίζουν να στέλνουν ηλεκτρικά σήματα στον νωτιαίο μυελό, μπλοκάροντας τα σήματα του πόνου.
Οι έως τώρα συσκευές μπλοκαρίσματος του νωτιαίου μυελού κατά του πόνου είναι ογκώδεις και απαιτούν επεμβατικό χειρουργείο, γι’ αυτό μόνο 50.000 τέτοιες επεμβάσεις γίνονται κάθε χρόνο παγκοσμίως (η σχετική θεραπεία θεωρείται ως μέτρο τελευταίας καταφυγής για όσους ασθενείς νιώθουν πολύ σοβαρούς και μη αντιμετωπίσιμους πόνους). Η νέα συσκευή είναι πολύ πιο μικρή σε μέγεθος (έχει πάχος μόλις 60 εκατομμυριοστά του μέτρου) και είναι πιο εύκολο να εισαχθεί στο σώμα.
Οι έως τώρα δοκιμές δείχνουν ότι η καινοτόμος συσκευή μπορεί να αποτελέσει μία αποτελεσματική θεραπεία για πολλές μορφές σοβαρού πόνου, όπως στα πόδια και στη μέση, που δεν μπορούν να αντιμετωπιστούν με αναλγητικά. Επίσης, θα μπορούσε πιθανώς να προσαρμοστεί για να αποτελέσει μία νέου τύπου θεραπεία της παράλυσης ή της νόσου Πάρκινσον.
Πάντως, θα απαιτηθούν μακράς διάρκειας τεστ και κλινικές δοκιμές πριν αξιοποιηθεί η συσκευή σε ασθενείς. Οι πρώτες δοκιμές της σε ανθρώπους αναμένονται σε δύο έως τρία χρόνια. Την εμπορική προώθηση της νέας τεχνολογίας έχει αναλάβει η Cambridge Enterprises, ο επιχειρηματικός βραχίονας του βρετανικού πανεπιστημίου.
Οι φωτογραφίες παραχωρήθηκαν από το Αθηναϊκό Πρακτορείο.
A comprehensive guide to the new science of treating lower back pain
A review of 80-plus studies upends the conventional wisdom.
By Julia Belluz@juliaoftoronto Updated Jul 27, 2018, 9:21am EDT
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Welcome to Show Me the Evidence, where we go beyond the frenzy of daily headlines to take a deeper look at the state of science around the most pressing health questions of the day.
CathrynCathryn Jakobson Ramin’s back pain started when she was 16, on the day she flew off her horse and landed on her right hip.
For the next four decades, Ramin says her back pain was like a small rodent nibbling at the base of her spine. The aching left her bedridden on some days and made it difficult to work, run a household, and raise her two boys.
By 2008, after Ramin had exhausted what seemed like all her options, she elected to have a “minimally invasive” nerve decompression procedure. But the $8,000 operation didn’t fix her back, either. The same pain remained, along with new neck aches.
At that point, Ramin decided to deploy her skills as a journalist and investigate the $100 billion back pain industry. She went on to write Crooked: Outwitting the Back Pain Industry and Getting on the Road to Recovery, an incredible tale of back pain and its treatment, published last May.
The big takeaway: Millions of back patients like Ramin are floundering in a medical system that isn’t equipped to help them. They’re pushed toward intrusive, addictive, expensive interventions that often fail or can even harm them, and away from things like yoga or psychotherapy, which actually seem to help. Meanwhile, Americans and their doctors have come to expect cures for everything — and back pain is one of those nearly universal ailments with no cure. Patients and taxpayers wind up paying the price for this failure, both in dollars and in health.
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Thankfully, Ramin finally discovered an exercise program that has eased her discomfort. And to this day, no matter how busy her life gets, she does a series of exercises every morning called “the McGill Big Three” (more on them later). “With very rare exceptions,” she says, “I find time to exercise, even when I’m on the road.”
More and more people like Ramin are seeking out conservative therapies for back pain. While yoga, massage, and psychotherapy have been around for a long time, there was little high-quality research out there to understand their effects on back pain, and doctors sometimes looked down on these practices. But over the past decade, that’s changed.
To learn more, I searched the medical literature on treatments for lower back pain (the most common type) and read through more than 80 studies (mainly reviews of the research that summarized the findings of hundreds more studies) about both “active” approaches (yoga, Pilates, tai chi, etc.) and passive therapies (massage, chiropractics, acupuncture, and so on). I also talked to nine experts and researchers in this field. (For more detail on our methods, scroll to the end.)
What I found surprised me: Many of these approaches really do seem to help, though often with modest effects. But when you compare even those small benefits with the harm we’re currently doing while medically “treating” back pain, the horror of the status quo becomes clear. “No one dies of low back pain,” one back pain expert, University of Amsterdam assistant professor Sidney Rubinstein, summed up, “but people are now dying from the treatment.”
Mainstream medicine has failed people with chronic back painLower back pain is one of the top reasons people go to the doctor in the US, and it affects 29 percent of adult Americans, according to surveys. It’s also the leading reason for missing work anywhere in the world. The US spends approximately $90 billion a year on back pain — more than the annual expenditures on high blood pressure, pregnancy and postpartum care, and depression — and that doesn’t include the estimated $10 to $20 billion in lost productivity related to back pain.
Doctors talk about back pain in a few different ways, but the kind most people (about 85 percent) suffer from is what they call "nonspecific low back pain." This means the persistent pain has no detectable cause — like a tumor, pinched nerve, infection, or cauda equina syndrome.
About 90 percent of the time, low back pain is short-lived (or in medical lingo, “acute”) and goes away within a few days or weeks without much fuss. A minority of patients, though, go on to have subacute back pain (lasting between four and 12 weeks) or chronic back pain (lasting 12 or more weeks).
Chronic nonspecific back pain is the kind the medical community is often terrible at treating. Many of the most popular treatments on offer from doctors for chronic nonspecific low back pain — bed rest, spinal surgery, opioid painkillers, steroid injections — have been proven ineffective in the majority of cases, and sometimes downright harmful.
Consider opioids. As of 2016, 14,500 Americans died from opioid-related deaths. Opioid prescribing is common among people with back pain, with almost 20 percent receiving long-term opioid prescriptions.
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