105080Restoring performance of the spine with a minimally invasive procedure, performed through a needleClosedFeasibility StudiesInnovate UK"Lower back pain is a worldwide health problem, affecting up to 85 % of people at some point in their life. It is often caused by degeneration, due to ageing of the intervertebral disc, which is located between two vertebrae and allows bending and twisting of the spine as well as resilience under compression. There is presently no method for repairing or replacing the intervertebral disc once it becomes damaged. As a result, patients with persistent back pain are typically offered physiotherapy or medication, which fails to address the underlying cause of pain and the associated loss of load-bearing capacity. In extreme cases, a surgeon operates to perform spinal fusion, whereby two adjacent vertebrae are fused together so as to eliminate that disc joint altogether: this is a major operation with a high failure rate which ultimately increases stresses on spine segments, causing subsequent degeneration. The overall aim of the present project is to enable the development of a new method to replace the disc, alleviate pain and restore movement without the need for major surgery. The whole procedure is designed to work with the insertion of a single, fine needle into the disc. This is used to inject a small amount of tiny gas bubbles into the centre of the disc. These are encouraged to oscillate violently by application of ultrasound from outside the body, which enables them to break the disc around them and create a void. A liquid material is then injected through the same needle that was used to introduce the bubbles in order to fill the void, which sets into a gel-like material that performs as a healthy disc. The specific aim of the project is to produce a prototype, stand-alone device that has all the right features to enable this technique to be used in hospitals. This will involve building a support gantry to couple the ultrasound to the patient's skin, a guiding system to introduce the needle into the disc safely, software to deliver, guide and monitor the treatment, and a gel recipe that can be efficiently manufactured and injected into the patient. The vision is to make this system sufficiently easy and safe to use that it does not require a major operation or significant hospital stay, and can help hundreds of thousands of patients not only with pain relief but with returning to a more active lifestyle."