Fundamentals of Intervertebral Disc Degeneration.

Publication Type	Academic Article
Authors	Kirnaz S, Capadona C, Wong T, Goldberg J, Medary B, Sommer F, McGrath L, Härtl R
Journal	World Neurosurg
Volume	157
Pagination	264-273
Date Published	01/01/2022
ISSN	1878-8769
Keywords	Intervertebral Disc Degeneration, Low Back Pain, Lumbar Vertebrae
Abstract	Lumbar disc degeneration is one of the leading causes of chronic low back pain. The degenerative cascade is often initiated by an imbalance between catabolic and anabolic processes in the intervertebral discs. As a consequence of extracellular matrix degradation, neoinnervation and neovascularization take place. Ultimately, this degenerative process results in disc bulging and loss of nucleus pulposus and water content and subsequent loss of disc height. Most patients respond to conservative management and surgical interventions well initially, yet a significant number of patients continue to suffer from chronic low back pain. Because of the high prevalence of long-term discogenic pain, regenerative biological therapies, including gene therapies, growth factors, cellular-based injections, and tissue-engineered constructs, have attracted significant attention in light of their potential to directly address the degenerative process. Understanding the pathophysiology of degenerative disc disease is important in both refining existing technologies and developing innovative techniques to reverse the degenerative processes in the discs. In this review, we aimed to cover the underlying pathophysiology of degenerative disc disease as well as its associated risk factors and give a comprehensive summary about the developmental, structural, radiological, and biomechanical properties of human intervertebral discs.
DOI	10.1016/j.wneu.2021.09.066
PubMed ID	34929784