Does Long-Term Compressive Loading on the Intervertebral Disc Cause Degeneration?

Hutton, William; Ganey, Timothy; Elmer, William A.; Kozłowska, Ewa; Ugbo, John L.; Doh, Eun-Sig; Whitesides, Thomas E.

doi:10.1097/00007632-200012010-00006

Cited by 98 publications

(72 citation statements)

References 25 publications

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“…It is possible that the process of restructuring is not fully completed after 28 days of compression treatment. This is supported by reports from Hutton et al [8] showing first visible changes after compression treatment on a gene expression level hours to days after initiating load. In contrast, on a biochemical basis visible changes were found after months.…”

Section: Discussionsupporting

confidence: 82%

“…Disc degeneration in animal models is still a matter of debate [1,[8][9][10][11][12][13]. Most studies with mechanically induced disc degeneration demonstrated a correlation between compression force and disc degeneration [1, 9, Fig.…”

Section: Discussionmentioning

confidence: 99%

“…The nucleus cells and, cells associated by invasion of blood vessels [18], are stimulated by mechanical compression. These cells respond with an upregulation of matrix degrading factors, which results in a reduction in hydrophilic proteoglycans explaining the decreased pressure in disc degeneration [8,28].…”

mentioning

confidence: 99%

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Intradiscal pressure measurements in normal discs, compressed discs and compressed discs treated with axial posterior disc distraction: an experimental study on the rabbit lumbar spine model

et al. 2005

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Section: Discussionsupporting

confidence: 82%

Section: Discussionmentioning

confidence: 99%

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Intradiscal pressure measurements in normal discs, compressed discs and compressed discs treated with axial posterior disc distraction: an experimental study on the rabbit lumbar spine model

et al. 2005

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“…28,29 Animal models can clarify pathomechanisms and aid in development of therapeutic strategies. While most animal models require mechanical or chemical induction, 4,[29][30][31][32][33][34][35][36][37][38] the macaque has naturally degenerating intervertebral discs (Fig. 1).…”

mentioning

confidence: 99%

Intervertebral disc degeneration in a naturally occurring primate model: Radiographic and biomechanical evidence

Nuckley

Kramer

Rosario

et al. 2008

Journal Orthopaedic Research

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Classic degenerative disc disease is a serious health problem worldwide, whose etiological basis-mechanical stimulus, biochemical changes, or natural aging-is poorly understood. Animal models are critical to the study of degenerative disc disease initiation and progression and for attempts to regulate, ameliorate, or eliminate it. The macaque represents a primate model with natural disc degeneration that might serve to advance the field; we aimed to provide radiographic (morphologic) and biomechanical evidence of natural disc degeneration in this model. A factorial study design was used to examine the relationship between the radiographic appearance of disc degeneration and its biomechanical consequences. Eighteen macaques of advanced age (22.3 AE 0.9 years) had radiographs taken to assess the degree of thoracolumbar intervertebral disc degeneration using a standard atlas method. Each spine was harvested and dynamic biomechanical tests were performed. Advancing disc degeneration (degree of disc space narrowing and osteophytosis) was associated with increased stiffness, decreased energy absorption, and increased natural frequency of the intervertebral disc. These associations linking the dynamics of the intervertebral disc and its degree of degeneration are similar to those found in humans. Our results indicate the macaque model with morphologic and biomechanical efficacy could aid in understanding the progression of disc degeneration and in developing therapeutic strategies to prevent or inhibit its course. Keywords: intervertebral disc; disc degeneration; Macaca fascicularis; disc dynamics; biomechanics Lumbar intervertebral discs change morphologically, biochemically, and biomechanically with advancing age, 1-10 changes that are characterized as disc degeneration and are implicated as the origin of low back pain. Unfortunately, the initiating and perpetuating factors of disc degeneration are unknown, so despite the pain, disability, and economic loss associated with disc degeneration, intervention and mitigation strategies cannot effectively proceed. Morphologically, dehydration and diminished cellularity of the nucleus pulposus and disorganization and lesions of the annulus fibrosus demarcate disc degeneration. These changes manifest as decreased disc height, increased radial bulging, and osteophyte formation. 11,12 Morphologic changes are intrinsically tied to the biochemistry and biomechanics of the system, and visible and radiographic changes are used to define gradations of disc degeneration. [13][14][15][16] The altered biomechanical response of degenerate disc tissues have been measured. [2][3][4][17][18][19][20][21][22][23][24] Disc stiffness decreases with low-grade degeneration and increases with the most severe degeneration, while energy absorption decreases throughout degeneration. Further, spinal segment range of motion and neutral zone increase with advancing degeneration up to the most severely degenerated discs, where these properties reverse course with increasing stiffness. Unfortun...

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“…In these studies, static compressive loads were applied to the discs via pins inserted into the adjacent vertebrae. The compressive load was created by coiled metal springs [14,16], cantilever metal springs [26], or Fig. 4 Typical load-displacement curves of the discs in sham and compression groups after the 2-week experimental period.…”

Section: Rationale Of the Experimentsmentioning

confidence: 99%

Effects of compressive loading on biomechanical properties of disc and peripheral tissue in a rat tail model

et al. 2009

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Intervertebral disc degeneration induced by mechanical compression is an important issue in spinal disorder research. In this study, the biomechanical aspect of the rat tail model was investigated. An external loading device equipped with super-elastic TiNi springs was developed to apply a precise load to the rat tail. By using this device, rat tail discs were subjected to compressive stress of 0.5 or 1.0 MPa for 2 weeks. Discs in the sham group received an attachment of the device but no loading. After the experimental period, first the intact tail with peripheral tissues (PT) such as tendon and skin and then the retrieved disc without PT were subjected to a uniaxial tension-compression test; biomechanical characteristics such as range of motion (ROM), neutral zone (NZ), and hysteresis loss (HL) were evaluated. Furthermore, the loadbearing contribution of PT in the intact tail was estimated by comparing the load-displacement curves obtained by the mechanical tests performed with and without PT. The experimental findings revealed that the continuous compressive stress induced reduction in disc thickness. The intact tail demonstrated decreases in ROM and NZ as well as increases in HL. On the other hand, the retrieved disc demonstrated increases in ROM, NZ, and HL. Further, a significant increase in the load-bearing contribution of PT was indicated. These findings suggest that the load-bearing capacity of the disc was seriously deteriorated by the application of compressive stress of 0.5 or 1.0 MPa for 2 weeks.

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Does Long-Term Compressive Loading on the Intervertebral Disc Cause Degeneration?

Cited by 98 publications

References 25 publications

Intradiscal pressure measurements in normal discs, compressed discs and compressed discs treated with axial posterior disc distraction: an experimental study on the rabbit lumbar spine model

Intradiscal pressure measurements in normal discs, compressed discs and compressed discs treated with axial posterior disc distraction: an experimental study on the rabbit lumbar spine model

Intervertebral disc degeneration in a naturally occurring primate model: Radiographic and biomechanical evidence

Effects of compressive loading on biomechanical properties of disc and peripheral tissue in a rat tail model

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