Low back pain (LBP) is the second leading cause of disability with global prevalence and is primarily caused by the degeneration of intervertebral disc (IVD) resulting in the compression of the spinal nerves and adjacent vertebrae. The real-world effect of degenerative IVD has a remarkable socio-economic impact and associated healthcare expenditure is estimated at over 100 billion dollars annually in the USA and €5.34 billion in Ireland alone. While IVD degeneration typically affects older people, younger patients also present with severe disc pain. Current therapy for IVD degeneration focuses on spinal fusion devices, which aim to alleviate pain through the removal of a damaged or diseased disc. While this approach has proven clinical benefit, many patients do not respond to this treatment and remain with chronic pain. Given the lack of satisfactory outcomes in treatment strategies for IVD degeneration, it is clear that new molecular targets need to identify at risk patients and to halt disc degeneration, restoring native tissue structure and function. Previous projects on IVD profiling revealed variable molecular signatures in patients undergoing discectomy. This project aims to further profile these discs and use molecular markers to identify patients at risk of disease and identify new targets for disease intervention. Sub-classification of patients using these precision medicine techniques will likely determine individual responses to future molecular-based therapies to provide patients with better outcomes.
