“Consequently, our team needed to regularly ‘pitch’ our study to crew that are in the International Space Station pipeline (called the Informed Consent Briefing, ICB). This was aided by the fact that one of our co-investigators, Scott Parazynski, was a former astronaut who suffered from a post-flight disc herniation (while he was climbing Mount Everest no less).”
“Also, because access to crew was so limited, we needed to make difficult choices in our study design. We couldn’t do everything we proposed (PET/CT for example) as often as we wanted. So we had to negotiate compromises with NASA administration.”
“Given our knowledge of the physics of how spinal discs behave (they osmotically swell at night, and compress with gravity during the day) and anecdotal reports of spine lengthening after space flight, we expected to see that crew returned home with supra-physiologically swollen discs.”
“This wasn’t the case however (a fact that was also noted by a separate research team using in-flight ultrasound). Rather, we observed that there was a significant atrophy of spinal stabilizing muscles, despite the rigorous in-flight exercise program designed by NASA ASCR’s (Astronaut Strength, Conditioning and Recondition specialists). Even with such a small sample (our first 6 of 12 crew) we noted a strong, statistically significant relationship between paraspinal muscle atrophy, lumbar lordosis, and spinal segment stiffness.”
“We recently held the first-ever joint meeting between NASA flight surgeons, ASCR’s, astronauts, and researchers focused on spine health. Our goal was to combine our observations and make recommendations to NASA for pre- and post-flight screening protocols to track spine health. We also discussed pre-, post-, and in-flight countermeasures that could be instituted to minimize the deleterious effects of microgravity.”
“We have also begun applying our NASA observations to back pain patients. For example, we have recently observed that paraspinal atrophy is significantly associated with disability in a cohort of chronic back pain patients. These observations suggest that interventions being designed by NASA that target the core spine stabilizers may be effective to treat back pain in patients.”
“The results of this study emphasize the fact that the spine is stabilized by both passive tissues (disc, vertebra, ligaments, and facets) and active tissues (muscles), and that synergy between those two stabilizing systems is necessary for pain free function. When developing new diagnostic and therapeutic strategies to help back pain patients we most often talk about the passive tissues—but there is an important stabilizing role that the deep stabilizing muscles play. These muscles are often ‘innocent bystander’ tissues damaged by surgery, a fact that may impair post-operative functioning in surgery patients.”
