Diseases and disorders of the musculoskeletal system are among the most
prevalent and costly medical conditions afflicting Western societies. In the
United States alone, musculoskeletal conditions are estimated to cost more
than $254 billion annually. Musculoskeletal injuries are the number-one
category of reported chronic impairment and rank number one in visits to
physicians' offices. Although few are fatal, many musculoskeletal conditions
are chronic and are associated with morbidity and a dramatically reduced
quality of life; collectively, they place a huge economic burden both on the
individuals who are afflicted with them and the health-care systems that are
responsible for coping with them. Moreover, because the incidence of many
musculoskeletal conditions increases with age, these disorders will become
even more prevalent as a result of shifting demographics.
In response, the American Academy of Orthopaedic Surgeons (AAOS), along
with the National Institutes of Health (NIH) and the National Institute of
Arthritis and Musculoskeletal and Skin Diseases (NIAMS), has worked for the
past eighteen years to develop and implement annual musculoskeletal research
symposia. Leading investigators from the greater musculoskeletal community
organize these symposia to discuss and define the state of the art as it
pertains to a topical area of orthopaedics. Attendance is by invitation only,
and the program content is largely determined by senior figures in the
relevant areas, acting as cochairs of the symposia. These meetings have played
an influential role in defining issues of importance to musculoskeletal
health, stimulating the research agendas of funding agencies, and providing a
supportive atmosphere in which veteran and young investigators can discover
new collaborative partners.
Research symposia consist of sessions, divided topically, with
presentations from principals in the field. All presentations are plenary, but
the agenda includes several "breakout sessions" in which the
all-symposium participants are divided into a number of small discussion
groups to address a specific area within the larger theme of the meeting.
Specifically, the breakout groups are charged with developing a series of
strategic questions that need to be answered and, if possible, providing
possible solutions. Developing these "future research directions"
is considered to be one of the most important functions of the symposia and
has led to numerous requests for applications and other such targeted research
initiatives.
The AAOS, along with several partners, hosted its Intervertebral Disc
Degeneration research symposium on September 15 through 18, 2005. The
symposium included national and international presenters and guests who are
experts in the field of the degenerative disc. Disc degeneration is a highly
common musculoskeletal impairment that currently has no identified cause;
however, a strong association exists between increasing age and progressive
degeneration. In fact, nearly everyone will show signs of disc degeneration at
fifty years of age. The use of magnetic resonance imaging has clarified that
degeneration starts at an early age and is present in more than one-third of
adults in their twenties. Occupational factors were previously thought to play
the major role, but recent studies indicate the importance of heredity. Over
the course of time, such degenerative changes may lead to secondary clinical
problems, such as disc herniations, degenerative spinal stenosis, and
degenerative spondylolisthesis.
The Intervertebral Disc Degeneration symposium addressed these and other
problems important to musculoskeletal health, specifically, evaluating the
biology of the intervertebral disc and disc degeneration, the biomechanics of
disc and disc degeneration, the mechanism of pain and disc degeneration,
modeling in disc degeneration, and treatment of disc degeneration.
The specific aims of the Intervertebral Disc Degeneration symposium were
to:
Define the current state of knowledge concerning intervertebral disc
degenerationIdentify areas of need for new basic and clinical researchDefine needs and opportunities for applications of advanced research to
clinical practiceIdentify future needs that will arise when translating the research to the
clinical settingDisseminate the outcomes through print and electronic publication for the
education of the musculoskeletal community and the practicing clinician
Define the current state of knowledge concerning intervertebral disc
degeneration
Identify areas of need for new basic and clinical research
Define needs and opportunities for applications of advanced research to
clinical practice
Identify future needs that will arise when translating the research to the
clinical setting
Disseminate the outcomes through print and electronic publication for the
education of the musculoskeletal community and the practicing clinician
This is the first time the results of an AAOS research symposium have been
disseminated through a journal supplement. It contains the manuscripts of
twenty presentations and details the recommended directions for future
research.
Support for the symposium and this supplement was received from:
The National Institutes of Health (The National Institute of Arthritis and
Musculoskeletal and Skin Diseases)The Orthopaedic Research Society
The National Institutes of Health (The National Institute of Arthritis and
Musculoskeletal and Skin Diseases)
The Orthopaedic Research Society
The AAOS acknowledges the following contributors for their financial
assistance in making the symposium and this supplement possible:
Zimmer Spine (Gold-Level Sponsor)EBI (Silver-Level Sponsor)Synthes Spine (Silver-Level Sponsor)DePuy Spine (Bronze-Level Sponsor)
Zimmer Spine (Gold-Level Sponsor)
EBI (Silver-Level Sponsor)
Synthes Spine (Silver-Level Sponsor)
DePuy Spine (Bronze-Level Sponsor)