Functional Spinal Unit Approach for Orthobiologic Injections for Low Back Pain

Area of Science:

• Spine biomechanics and regenerative medicine.
• Orthobiologics and pain management.

Background:

• Low back pain (LBP) is a complex condition with multifactorial origins.
• Traditional treatments often target single pain generators, overlooking the interconnectedness of spinal structures.

Purpose of the Study:

• To review the concept of the functional spinal unit (FSU).
• To evaluate orthobiologics like platelet-rich plasma (PRP) and mesenchymal stem cells (MSCs) for treating back pain.

Main Methods:

• A narrative literature review was conducted.
• Searches included PubMed, Embase, and Google Scholar for studies on FSU anatomy, biomechanics, pathology, and orthobiologic applications in spinal disorders.

Main Results:

• The FSU, comprising vertebrae, IVD, facet joints, and ligaments, is key to spinal function.
• Orthobiologics (PRP, MSCs) show potential in tissue repair and pain reduction by targeting multiple FSU components.
• Chronic LBP often involves multiple pain generators, necessitating an integrated FSU-focused treatment approach.

Conclusions:

• Orthobiologic treatments offer a disease-modifying strategy by addressing the entire FSU.
• Further research is needed to optimize multitarget injection strategies and standardize protocols for LBP management.