Background: Chondroitin sulfate (CS) is a glycosaminglycan constructed of repeating disaccharide units with the presence of an amino sugar and different sulfated positions. This compound is present in the extracellular matrix especially in the cartilage, skin, blood vessels, ligaments and tendons. CS aside of being a building material for the cartilage it also has anti-inflammatory and antioxidant effects. For these reasons CS is currently being therapeutically used for the treatment of osteoarthritis (OA) in many countries under the commercial name Chondroguard®. Aims: This review critically analyzes the therapeutic properties of CS in the vertebral unit by assessing relevant in vitro and in vivo data published during the last decades in the specialized literature. The molecular-physiological mechanisms of action of CS in intervertebral disc extrusions and protrusions, in inflammation and neuroprotection are discussed. Conclusions: The clinical data obtained during years of treatment with CS and the utility of this molecule to protect the functional spinal unit are also considered to highlight their potential to treat OA worldwide.
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