Effects of Nucleus Pulposus on Nerve Root Neural Activity, Mechanosensitivity, Axonal Morphology, and Sodium Channel Expression

Chen, Chaoyang; Cavanaugh, John M.; Song, Zheng; Takebayashi, Toru; Kallakuri, Srinivasu; Wooley, Paul H.

doi:10.1097/01.brs.0000096675.01484.87

Cited by 65 publications

(34 citation statements)

References 39 publications

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“…71 They appear to become sensitized to mechanical loading, and animal experiments have confirmed that contact with nucleus pulposus can lower nerve stimulation thresholds in adjacent tissues. 72 Pain sensitization is of most functional significance when it occurs in the outer anulus fibrosus because that is where the highest stress concentrations are found in "degenerated" discs ( Figure 3C). …”

Section: Discogenic Painmentioning

confidence: 99%

What is Intervertebral Disc Degeneration, and What Causes It?

Adams¹,

Roughley²

2006

Spine

1,484

1,288

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Section: Discogenic Painmentioning

confidence: 99%

What is Intervertebral Disc Degeneration, and What Causes It?

Adams¹,

Roughley²

2006

Spine

1,484

1,288

View full text Add to dashboard Cite

“…15 This usually results from contact of extruded nuclear material with the dorsal root ganglia, resulting in the release of inflammatory byproducts and/or endoneurial edema resulting from reduced blood flow caused by pressure of the extruded material on the dorsal root ganglion. 20,28,29,56,122 This condition is most common in young and early middle-aged adults, and is rare in older adults or in severely degenerated discs that have limited fluid left in the nucleus. 5 Small and medium-sized herniations are often seen in asymptomatic people; however, large herniations (extrusions) and/or severe nerve compression are highly likely to be associated with ipsilateral, distal lower extremity pain.…”

Section: 83mentioning

confidence: 99%

Current Understanding of Lumbar Intervertebral Disc Degeneration: A Review With Emphasis Upon Etiology, Pathophysiology, and Lumbar Magnetic Resonance Imaging Findings

Beattie¹

2008

J Orthop Sports Phys Ther

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The lumbar intervertebral discs (IVDs) are of critical importance for the support and mobility of the spine. 16,54,71 These remarkable tissues have the capacity to maintain stability under a wide variety of loading conditions, while still permitting intersegmental motion. 7,16 Unfortunately, the lumbar IVDs undergo more destructive changes over a lifetime than do any other musculoskeletal tissues 53 and often contribute directly, or indirectly, to the symptoms of low back pain and sciatica. 61,62,90,91 decades. 18,44,51,53 Not surprisingly, DD is the most common condition affecting the adult spine and is the reason for over 90% of all adult spinal surgeries. 8Although exact data are lacking, it is quite likely that a high percentage of adults seeking physical therapy care for low back pain and/or sciatica will have imaging evidence of lumbar DD at 1 or more spinal levels. The exact role that these findings play in symptom generation is, however, often unknown. For example, several population-based or case control studies have also reported a high prevalence of DD in asymptomatic people. 19,57,97 This has led to a lack of consensus regarding the importance of the presence of DD relative to determining patient prognosis and treatment.Over the past several years, a growing body of evidence has provided valuable information regarding the etiology of lumbar DD 6,13,50,105,116 and the pathophysiology of the degenerative lumbar IVD. 5,27,58,70,94,99,101 This information will assist clinicians and researchers in understanding the development and clinical course of lumbar DD and its potential impact upon patients seeking physical therapy care for back pain. Although abnormalities of the lumbar IVD can manifest in many different ways, such as bulging or herniation, the common central feature to most disc pathology is the process of specific degenerative changes that occurs within the nucleus, annulus, and adjacent bony tissue. 5,8,98 This complex process of cell-mediated structural changes occurs over a lifespan, with signs of disc degeneration (DD) often present by the third decade of life, and almost universal by the seventh and eighth SYNOPSIS: Degeneration of the lumbar intervertebral discs (IVDs) is highly prevalent in adults and nearly universal in the elderly population. Degenerative changes within, and adjacent to, the IVDs are likely to contribute to a variety of pain syndromes; however, the exact association between these findings and symptoms remains speculative. Recent research has provided new information regarding the etiology, pathophysiology, and clinical relevance of degeneration of the IVD. This information will assist clinicians and researchers in understanding the development and clinical course of lumbar disc degeneration, as well as its potential impact upon patients seeking physical therapy care for back pain. The purposes of this clinical commentary are to review the structure and metabolic capacity of the normal and degenerative lumbar IVD, and to discuss factors that influence the onset and progr...

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“…Mechanical decompression of the nucleus pulpous with partial emptying of the disc space with consequent pressure lowering inside the disc space is considered as a mechanical explanation of the procedure (6). The other mechanism that has been hypothesized is a chemical disruption of degenerative metabolic processes inside the disc space which may induce changes in disc metabolism related to inflammation and/or initiate an autoimmune response in surrounding tissue to affect pain symptomatology (7)(8)(9).…”

Section: Dear Editormentioning

confidence: 99%