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Disc herniations in astronauts: What causes them, and what does it tell us about herniation on earth?

PainSci » bibliography » Belavy et al 2016
updated
Tags: etiology, spine, back pain, neck, fun, neat, pro, pain problems, head/neck

Three pages on PainSci cite Belavy 2016: 1. The Complete Guide to Low Back Pain2. 6 Main Causes of Morning Back Pain3. Zero-G and spines

PainSci notes on Belavy 2016:

Astronauts get more intervertebral disc herniations when they come down to Earth, probably because the darn things swell up in zero-G. We’re used to thinking about disc herniation as something that happens because of gravity … not because it’s absent! I’m sure most of us probably assume that taking the pressure off is nice for spines (and maybe it is while you’re still floating around).

But apparently discs get a bit poofy and unstable if you don’t keep the pressure on ‘em.

original abstract Abstracts here may not perfectly match originals, for a variety of technical and practical reasons. Some abstacts are truncated for my purposes here, if they are particularly long-winded and unhelpful. I occasionally add clarifying notes. And I make some minor corrections.

PURPOSE: Recent work showed an increased risk of cervical and lumbar intervertebral disc (IVD) herniations in astronauts. The European Space Agency asked the authors to advise on the underlying pathophysiology of this increased risk, to identify predisposing factors and possible interventions and to suggest research priorities.

METHODS: The authors performed a narrative literature review of the possible mechanisms, and conducted a survey within the team to prioritize research and prevention approaches.

RESULTS AND CONCLUSIONS: Based on literature review the most likely cause for lumbar IVD herniations was concluded to be swelling of the IVD in the unloaded condition during spaceflight. For the cervical IVDs, the knowledge base is too limited to postulate a likely mechanism or recommend approaches for prevention. Basic research on the impact of (un)loading on the cervical IVD and translational research is needed. The highest priority prevention approach for the lumbar spine was post-flight care avoiding activities involving spinal flexion, followed by passive spinal loading in spaceflight and exercises to reduce IVD hyper-hydration post-flight.

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