“…Occupational exposures such as vibration [26], mechanical influences such as heavy lifting and weight [27], unhealthy lifestyle such as lack of exercise [28] and smoking [29,30], and the long use of non-Swedish and non-Japanese cars [31] have been blamed for contributing to disc degeneration and associated herniation. Trauma is also suggested as a contributor to IDD [32,33]. On the other hand, genetic contributions have been confirmed by identifying the polymorphisms of many key genes involved in the degeneration of IVD, including a disintegrin and metalloprotease with thrombospondin motif (ADAMTS)-4 [34], ADAMTS-5 [35], matrix metalloproteinase (MMP)-2 [36], MMP-3 [37], MMP-9 [38], MMP-14 [39], aggrecan [40], and vitamin D receptor [41,42].…”