The Course of Macroscopic Degeneration in the Human Lumbar Intervertebral Disc

Haefeli, Mathias; Kalberer, Fabian; Saegesser, Daniel; Nerlich, Andreas G.; Boos, Norbert; Paesold, Günther

doi:10.1097/01.brs.0000222032.52336.8e

Cited by 201 publications

(177 citation statements)

References 21 publications

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“…Concentric and radial tears were found to be frequent in young discs as well as in specimens harvested from elderly donors. However, studies showed that the presence of radial tears increases with ageing [28,30]. Rim lesions and endplate separations had higher incidence in the 50-80 age group [69].…”

Section: Structural Changesmentioning

confidence: 97%

“…The ageing intervertebral disc usually shows several changes in comparison to the young, healthy disc, even in asymptomatic subjects [28]. 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.…”

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: Structural Changesmentioning

confidence: 97%

Section: Ageing and Degenerative Changes Of The Intervertebral Discmentioning

confidence: 99%

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

et al. 2014

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“…In terms of the progression of degenerative disc disease, the NP could arguably represent the lynchpin in the degenerative cascade since many investigators consider the NP as the area demonstrating the earliest degenerative changes [9-11]. We may therefore need to look ever closer at the question of what really defines the cells within the disc.…”

mentioning

confidence: 99%

The enigma that is the nucleus pulposus cell: the search goes on

Erwin

2010

Arthritis Research & Therapy

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The development of an effective treatment for degenerative disc disease has been hampered for many years by what seems a fundamental problem; what exactly defines a nucleus pulposus (NP) cell? The paper by Gilson and colleagues elegantly re-opens the debate concerning the lineage and identity of NP cells that are alike yet different from chondrocytes. As we pursue novel investigations and treatment strategies for degenerative disc disease, how do we isolate these unique cells and what is the role of the primordial notochordal cell that may well linger within the NP far longer and perhaps in a different phenotypic appearance than previously thought? The paper by Gilson and colleagues that is the subject of the present editorial presents compelling data concerning the heterogeneity of the cells of the NP, and their origin, development, maturation and function.

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“…2,[6][7][8][9] However, representation from the first 2 decades of life has been relatively small in these studies, ranging from 19 to 50 disks, 6,9 possibly explaining a lack of direct statistical analysis focused on the young disks. Studies that do focus on the disk degeneration in children either have not included annular tears in their analysis 10,11 or have mainly looked at the clinical implications of annular tears.…”

mentioning

confidence: 99%