“…The classic twin experiment confirmed the genetic correlation of IVDD and LBP to some extent ( Battié et al, 1995 ; Battié et al, 2007 ). Moreover, genetic polymorphism studies may also provide a basis for this, as genetic polymorphisms in inflammatory factors (IL-1α/β, IL-6, and TNF-α), MMPs (MMP-1, -2, -3), collagen (COL), aggrecan (ACAN), and cartilage intermediate proteins may be associated with the pathogenesis of IVDD in populations from several countries ( Mayer et al, 2013 ; Harshitha et al, 2018 ; Trefilova et al, 2021 ). It is well known that both prolonged compression, strain, and acute nonphysiological loading acting on the IVD can lead to a range of changes, such as tissue damage, reduced vascular buds, decreased cellular activity, inflammatory factor release, and ECM degradation ( Alkhatib et al, 2014 ; Zhan et al, 2020 ; Zhan et al, 2021 ; Zhou et al, 2021 ), which ultimately result in IVDD.…”