Pathophysiology of lumbar disc degeneration: a review of the literature

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Lumbar disc degeneration occurs because of a variety of factors and results in a multitude of conditions. Alterations in the vertebral endplate cause loss of disc nutrition and disc degeneration. Aging, apoptosis, abnormalities in collagen, vascular ingrowth, loads placed on the disc, and abnormal proteoglycan all contribute to disc degeneration. Some forms of disc degeneration lead to loss of height of the motion segment with concomitant changes in biomechanics of the segment. Disc herniation with radiculopathy and chronic discogenic pain are the result of this degenerative process.

Abbreviations used in this paper:ALL = anterior longitudinal ligament; IL = interleukin; MMP = matrix metalloproteinase; NO = nitric oxide; PG = prostaglandin; PGE = prostaglandin E; PLL = posterior longitudinal ligament; VB = vertebral body.

Lumbar disc degeneration occurs because of a variety of factors and results in a multitude of conditions. Alterations in the vertebral endplate cause loss of disc nutrition and disc degeneration. Aging, apoptosis, abnormalities in collagen, vascular ingrowth, loads placed on the disc, and abnormal proteoglycan all contribute to disc degeneration. Some forms of disc degeneration lead to loss of height of the motion segment with concomitant changes in biomechanics of the segment. Disc herniation with radiculopathy and chronic discogenic pain are the result of this degenerative process.

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Address reprint requests to: David G. Malone, M.D., Oklahoma Spine and Brain Institute, 1919 South Wheeling, Tulsa, Oklahoma 74104. email: xmalone@cox.net.

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