Pathophysiology of degenerative intervertebral disc disease
Keywords:
degeneration, intervertebral disc, pathophysiology, cellular senescenceAbstract
Introduction: The intervertebral disc is composed of fibrous and cartilaginous connective tissues that border two adjacent vertebrae. Discs have poor innate healing potential, as they constitute avascular and aneural structures with few cells.
Objective: To discuss the most current knowledge on the pathophysiology of degenerative disc disease.
Methods: Articles on the most recent scientific advances related to the pathophysiology of intervertebral disc degeneration and its relationship to low back pain were reviewed.
Purpose: Low back pain is associated with the degenerative process of the intervertebral disc. Disorders resulting from disc aging include the accumulation of damaged proteins, mitochondrial dysfunction, telomere shortening, DNA deterioration, and the deterioration of quality control mechanisms (autophagy, DNA repair). Disc cells develop a cellular senescence phenotype, influenced by stress mechanisms such as oxidative, genotoxic, inflammatory, mechanical, and nutritional stress.
Conclusions: Low back pain is a common and difficult-to-treat problem linked to degenerative changes in the intervertebral discs. Degeneration occurs due to altered disc homeostasis. The degenerative cascade begins with the degradation of the extracellular matrix, resulting from the loss of proteoglycans, water content, and disc height.
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