What is Intervertebral Disc Degeneration, and What Causes It?

  title={What is Intervertebral Disc Degeneration, and What Causes It?},
  author={Michael A. Adams and Peter J. Roughley},
Study Design. Review and reinterpretation of existing literature. Objective. To suggest how intervertebral disc degeneration might be distinguished from the physiologic processes of growth, aging, healing, and adaptive remodeling. Summary of Background Data. The research literature concerning disc degeneration is particularly diverse, and there are no accepted definitions to guide biomedical research, or medicolegal practice. Definitions. The process of disc degeneration is an aberrant, cell… 

Anatomy and pathophysiology of intervertebral disc disease

This article attempts to explore the anatomy of the disc and the different perturbations that occur following aging and degeneration and discusses the evidence that has accumulated regarding the occurrence of pathologic changes from a genetic and ergonomic perspective.


The results indicate that regardless of age or condition, the intervertebral disc undergoes long and extensive remodeling of its constituents, which are influenced by several factors: environmental, soluble, cell growth and extracellular matrix.

The etiology of intervertebral disc degeneration

How disc degeneration can be distinguished from normal disc aging is described and factors associated with intervertebral Disc degeneration are reviewed, with a focus on genetic factors in particular.

Lumbar Intervertebral Disk Injury, Herniation and Degeneration

This chapter reviews the mechanical function and failure of lumbar intervertebral discs and describes the two distinct ‘phenotypes’ of disc degeneration: annulus driven and endplate driven.

Degeneration and regeneration of the intervertebral disc: lessons from development

How model systems have advanced the understanding of embryonic morphogenesis and associated molecular signaling pathways, in addition to the postnatal changes to the cellular, nutritional and mechanical microenvironment, is examined.

Molecular basis of intervertebral disc degeneration.

This work will provide a brief overview of the anatomic, cellular, and molecular structure of the IVD, and delve into the cellular and molecular pathophysiology surrounding IVD degeneration.

Treatment of Intervertebral Disc Degeneration

There are many problems that need to be solved if the new biotherapy is to be applied to clinical treatment of intervertebral disc degeneration and this article mainly reviews the treatment strategies and research progress of IDD.

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

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.



Animal Models of Intervertebral Disc Degeneration: Lessons Learned

These models suggest that two stages of architectural remodeling exist in humans: early adaptation to gravity loading, followed by healing meant to reestablish biomechanical stability that is slowed by tissue avascularity.

Aging and degeneration of the human intervertebral disc.

Although aging changes of the disc appear to be inevitable, identification of activities and agents that accelerate these changes may help decrease the rate and severity of disc degeneration; and recent work suggests that methods can be developed that will regenerate disc tissue.

Biology of Intervertebral Disc Aging and Degeneration: Involvement of the Extracellular Matrix

Current research is aimed at trying to restore the integrity of the degenerate disc matrix by biologic means, although at present it is not clear what the structure of the most appropriate repair tissue should be or how it can be achieved.

Mechanical initiation of intervertebral disc degeneration.

Comparisons with the results from tissue culture experiments indicated that the observed changes in matrix compressive stress would inhibit disc cell metabolism throughout the disc, and could lead to progressive deterioration of the matrix.

Classification of Age-Related Changes in Lumbar Intervertebral Discs: 2002 Volvo Award in Basic Science

Histologic disc alterations can reliably be graded based on the proposed classification system providing a morphologic framework for more sophisticated molecular biologic analyses of factors leading to age-related disc changes.

The Origin and Fate of Herniated Lumbar Intervertebral Disc Tissue

The autopsy study confirmed the model of nuclear fragmentation, migration, and extrusion along radiating anular clefts and found that neovascularization of extruded fragments bore no relationship with duration of sciatic pain symptoms or clinical outcome.

Lumbar Disc Degeneration: Epidemiology and Genetic Influences

There are extreme variations in the reported prevalence of specific degenerative findings of the lumbar spine among studies, which cannot be explained entirely by age or other identifiable risk factors, and heredity has a dominant role in disc degeneration.

Matrix Metalloproteinases: The Clue to Intervertebral Disc Degeneration?

The characteristics of matrix metalloproteinases are detail to detail (classification, structure, substrate specificity and regulation) and to report previous studies of intervertebral discs to highlight the importance of this field of application in chronic low back pain.

Biomechanics of Back Pain

  • M. Adams
  • Medicine
    Acupuncture in medicine : journal of the British Medical Acupuncture Society
  • 2004
A mechanistic account of back pain is offered which attempts to incorporate all of the most important recent advances in spinal research, and the concept of ‘functional pathology’ is introduced, according to which, back pain can arise because postural habits generate painful stress concentrations within innervated tissues, even though the stresses are not high enough to cause physical disruption.

Experimental Disc Degeneration Due to Endplate Injury

Experimental degeneration of the intervertebral disc induced by endplate penetration resembled human disc degeneration, as exemplified by biochemical and structural changes.