|
Jeff Lotz, PhD
Assistant Professor in Residence
Bio Mechanics
Jeffery Lotz graduated with a Bachelors of Science in Mechanical Engineering from the University of California, Berkeley in 1979. He went on to receive a Masters of Science in Mechanical Engineering Design from Stanford University in 1980. Jeff entered the doctoral program in Medical Engineering from Massachusetts Institute of Technology/Harvard Division of Health Science and Technology graduating in 1988.
After five years in private industry he joined the Jeff joined the Orthopaedic Surgery faculty as an Assistant Professor and Director of the Orthopaedic Bioengineering Laboratory at the Parnassus campus in 1993. In 1998 Jeff was promoted to Associate Professor and Director, Orthopaedic Bioengineering Laboratory, and in 2002 he was promoted again to Professor and Director, Orthopaedic Bioengineering Laboratory.
Dr. Lotz' Orthopaedic Bioengineering Laboratory takes a unique, multidisciplinary approach to understanding the complex interrelationships between the biologic tissues of the spine and the mechanical stresses and forces that can injure it. Calling on the expertise of scientists across an array of disciplines - medicine, engineering, molecular biology, computer science and more - the Laboratory is rapidly advancing our understanding of injury to the spine, what emerging treatments hold most promise, and which preventive measures will be most successful in avoiding degenerative spinal disease.
Back injuries account for 80 percent of all workplace injury claims, and more loss of productivity than any other medical condition. Acute low-back pain and the resulting disability is extraordinarily widespread: more than 4 million people each year report a new prolapsed disc - in lay terms, a herniated or 'slipped' disc. In addition to the personal discomfort and loss of productivity, the societal costs are also staggering. Acute back pain presents to this country's health care system an annual bill of over $50 billion.
The traditional treatment or intractable, severe back pain has been the laminectomy, a surgical procedure that removes bone from the vertebrae, thus relieving compression of the spinal cord. If several laminae are removed, spinal fusion may be necessary to ensure stability of the spine. The laminectomy is therefore an irreversible procedure that may limit mobility and yet does not always eliminate or even reduce pain.
Already, the Laboratory's multidimensional approach has yielded a new and different understanding about the nature of disc injury. Orthopedists have long understood that back pain is associated with dehydration of the intervertebral disc. In a healthy spine, the center of the disc is composed of a hydrated gel-like substance, surrounded by a tough, flexible ring. When disc tissue degenerates - often because it has been subject to excessive force or 'loading',- it can lose its gel-like texture, along with its ability to maintain proper distribution of mechanical stress and strains. Disc regions may be subjected to loads for which they are not well-suited and the tissue may alter as a result. This may pressure spinal nerves and cause pain.
Contrary to the prevailing notion that back injuries are discrete, sudden events, the Bioengineering teams findings suggest that these injuries are cumulative in nature. Disc degeneration is very common and in most patients asymptomatic until a specific event triggers pain: thus, the impression among patients and most of the medical community that an action "threw the back out". The Bioengineering Groups research indicates that while a final event may have triggered the pain, the underlying abnormality was in all likelihood already present, probably for some period of time.
A better fundamental understanding of the interplay between biology and mechanics is necessary to take the next steps in disc degeneration research. Specifically, the UCSF team seeks the knowledge base from which to develop appropriate, effective treatments and preventive measures. The goal is to relieve the injuries of those who currently suffer, and prevent the disease in those whose anatomy or occupations put them at high risk for developing disc degeneration.
The Lab is exploring spinal disc treatments that are biologic rather than surgical in nature. Recognizing the dehydration is responsible for disc degeneration, a number of possible interventions seek to restore moisture to disc tissue. Certain biochemical agents known as growth factors - some synthetically produced and some extracted from animals - show promise for rehydrating and repressurizing disc which have degenerated. Study is underway to determine its effectiveness in restoring or replacing the gel in the middle of the disc.
Prevention is another area of particular interest. A complex interplay of anatomy and mechanical forces determines an individuals risk for developing serious disc degeneration. With a more complete and accurate understanding of how tissue responds to force, UCSF scientists hope to redefine state-of-the-art screening techniques. This knowledge will also be helpful in the ergonomic design of automobiles, equipment and workstation furniture; the development of occupational health and safety standards: and a whole host of other home and workplace design standards the prevent spinal injury.
|
