What is Intervertebral Disc Degeneration, and What Causes It?

Adams, Michael A.; Roughley, Peter J.

doi:10.1097/01.brs.0000231761.73859.2c

Cited by 1,482 publications

(1,406 citation statements)

References 114 publications

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“…This higher concentration of cations gives the disc an osmotic pressure (Donnan equilibrium) with respect to the external environment and, thus, the capacity to attract and imbibe water [66]. Due to its high water content, low permeability and osmotic properties, the nucleus is, therefore, able to sustain high compressive forces [4]. The NP swelling pressure is balanced by the hydrostatic pressure, which is a result of the NP being contained by the endplates and the AF.…”

Section: Functional Anatomy Of the Intervertebral Discmentioning

confidence: 99%

“…The boundary between physiologic disc ageing and degenerative disc disease is not always clear, since in most cases ageing and degenerative changes do not substantially differ. Disc degeneration has been defined as an accelerated ageing process including structural failure [4]. Nevertheless, purely physiological ageing changes such as water loss and thus the so-called ''black disc'' have been also referred to as disc degeneration [52], thus promoting confusion in the literature due to different definitions of disc degeneration.…”

Section: Ageing and Degenerative Changes Of The Intervertebral Discmentioning

confidence: 99%

“…Nevertheless, purely physiological ageing changes such as water loss and thus the so-called ''black disc'' have been also referred to as disc degeneration [52], thus promoting confusion in the literature due to different definitions of disc degeneration. The following paragraphs are based on the aforementioned definition by Adams [4].…”

Section: Ageing and Degenerative Changes Of The Intervertebral Discmentioning

confidence: 99%

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Ageing and degenerative changes of the intervertebral disc and their impact on spinal flexibility

et al. 2014

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Purpose Degeneration of the intervertebral disc is associated with various morphological changes of the disc itself and of the adjacent structures, such as reduction of the water content, collapse of the intervertebral space, disruption and tears, and osteophytes. These morphological changes of the disc are linked to alterations of the spine flexibility. This paper aims to review the literature about the ageing and degenerative changes of the intervertebral disc and their link with alterations in spinal biomechanics, with emphasis on flexibility. Methods Narrative literature review. Results Clinical instability of the motion segment, usually related to increased flexibility and hypothesized to be connected to early, mild disc degeneration and believed to be responsible for low back pain, was tested in numerous in vitro studies. Despite some disagreement in the findings, a trend toward spinal stiffening with the increasing degeneration was observed in most studies. Tests about tears and fissures showed inconsistent results, as well as for disc collapse and dehydration. Vertebral osteophytes were found to be effective in stabilizing the spine in bending motions. Conclusions The literature suggests that the degenerative changes of the intervertebral disc and surrounding structures lead to subtle alteration of the mechanical properties of the functional spinal unit. A trend toward spinal stiffening with the increasing degeneration has been observed in most studies.

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Section: Functional Anatomy Of the Intervertebral Discmentioning

confidence: 99%

Section: Ageing and Degenerative Changes Of The Intervertebral Discmentioning

confidence: 99%

Section: Ageing and Degenerative Changes Of The Intervertebral Discmentioning

confidence: 99%

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Ageing and degenerative changes of the intervertebral disc and their impact on spinal flexibility

et al. 2014

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“…Disc degeneration is related to progressive changes in the lumbar intervertebral discs, involving both tissue biology and mechanics [5]. Both genetic inheritance [9,10] and high mechanical loading [1,4,26] were identified as possible causes of this pathology.…”

Section: Introductionmentioning

confidence: 99%

“…Both genetic inheritance [9,10] and high mechanical loading [1,4,26] were identified as possible causes of this pathology. Once the process is initiated, a cascade of inevitable cell-mediated responses starts, leading to further degenerative phenomena [5]. Some of these phenomena, such as osteophytosis and decreased cell density, may simply reflect a remodeling response to altered mechanical loading, spinal stability and impaired nutrition [8].…”

Section: Introductionmentioning

confidence: 99%

The mechanical response of the lumbar spine to different combinations of disc degenerative changes investigated using randomized poroelastic finite element models

et al. 2010

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Degeneration of the intervertebral disc is related to progressive changes in the disc tissue composition and morphology, such as water loss, disc height loss, endplate calcification, osteophytosis. These changes may be present separately or, more frequently, in various combinations. This work is aimed to the biomechanical investigation of a wide range of clinical scenarios of disc degeneration, in which the most common degenerative changes are present in various combinations. A poroelastic non-linear finite element model of the healthy L4-L5 human spine segment was employed and randomly scaled to represent ten spine segments from different individuals. Six different degenerative characteristics (water loss in the nucleus pulposus and annulus fibrosus; calcification and thickness reduction of endplate cartilage; disc height loss; osteophyte formation; diffuse sclerosis) were modeled in 30 randomly generated models, 10 for each overall degree of degeneration (mild, moderate, severe). For each model, a daily loading cycle including 8 h of rest, 16 h in the standing position with superimposed two flexion-extension motion cycles was simulated. A tendency to an increase of stiffness with progressing overall degeneration was observed, in compression, flexion and extension. Hence, instability for mild degeneration was not predicted. Facet forces and fluid loss decreased with disc degeneration. Nucleus, annulus and endplate degeneration, disc height loss, osteophytosis and diffuse sclerosis all induced a statistically significant decrease in the total daily disc height variation, facet force and flexibility in flexion-extension. Therefore, grading systems for disc degeneration should include all the degenerative changes considered in this work, since all of them had a significant influence on the spinal biomechanics.

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“Discogenic” Pain (Signs Associated With Disc Degeneration But Without Herniation)

Fingeroth¹,

Melrose²

2014

Advances in Intervertebral Disc Disease in Dogs and Cats

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What is Intervertebral Disc Degeneration, and What Causes It?

Cited by 1,482 publications

References 114 publications

Ageing and degenerative changes of the intervertebral disc and their impact on spinal flexibility

Ageing and degenerative changes of the intervertebral disc and their impact on spinal flexibility

The mechanical response of the lumbar spine to different combinations of disc degenerative changes investigated using randomized poroelastic finite element models

“Discogenic” Pain (Signs Associated With Disc Degeneration But Without Herniation)

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