Journal ArticleDOI
Histology and pathology of the human intervertebral disc
TLDR
The intervertebral disc is a highly organized matrix laid down by relatively few cells in a specific manner that allows the discs to facilitate movement and flexibility within what would be an otherwise rigid spine.Abstract:
The intervertebral disc is a highly organized matrix laid down by relatively few cells in a specific manner. The central gelatinous nucleus pulposus is contained within the more collagenous anulus fibrosus laterally and the cartilage end plates inferiorly and superiorly. The anulus consists of concentric rings or lamellae, with fibers in the outer lamellae continuing into the longitudinal ligaments and vertebral bodies. This arrangement allows the discs to facilitate movement and flexibility within what would be an otherwise rigid spine. At birth, the human disc has some vascular supply within both the cartilage end plates and the anulus fibrosus, but these vessels soon recede, leaving the disc with little direct blood supply in the healthy adult. With increasing age, water is lost from the matrix, and the proteoglycan content also changes and diminishes. The disc—particularly the nucleus—becomes less gelatinous and more fibrous, and cracks and fissures eventually form. More blood vessels begin to grow into the disc from the outer areas of the anulus. There is an increase in cell proliferation and formation of cell clusters as well as an increase in cell death. The cartilage end plate undergoes thinning, altered cell density, formation of fissures, and sclerosis of the subchondral bone. These changes are similar to those seen in degenerative disc disease, causing discussion as to whether aging and degeneration are separate processes or the same process occurring over a different timescale. Additional disorders involving the intervertebral disc can demonstrate other changes in morphology. Discs from patients with spinal deformities such as scoliosis have ectopic calcification in the cartilage end plate and sometimes in the disc itself. Cells in these discs and cells from patients with spondylolisthesis have been found to have very long cell processes. Cells in herniated discs appear to have a higher degree of cellular senescence than cells in nonherniated discs and produce a greater abundance of matrix metalloproteinases. The role that abnormalities play in the etiopathogenesis of different disorders is not always clear. Disorders may be caused by a genetic predisposition or a tissue response to an insult or altered mechanical environment. Whatever the initial cause, a change in the morphology of the tissue is likely to alter the physiologic and mechanical functioning of the tissue.read more
Citations
More filters
Journal ArticleDOI
Role of cytokines in intervertebral disc degeneration: pain and disc content.
TL;DR: An enhanced understanding of the contribution of cytokines and immune cells to these catabolic, angiogenic and nociceptive processes could provide new targets for the treatment of symptomatic disc disease.
Journal Article
Comprehensive Evidence-Based Guidelines for Interventional Techniques in the Management of Chronic Spinal Pain
Laxmaiah Manchikanti,Mark V. Boswell,Vijay Singh,Ramsin M Benyamin,Bert Fellows,Salahadin Abdi,Ricardo M. Buenaventura,Ann Conn,Richard Derby,Stephanie Erhart,Sudhir Diwan,Salim M. Hayek,Allan T. Parr,David M. Schultz,Howard S. Smith,Lee R. Wolfer,Joshua A Hirsch +16 more
TL;DR: These guidelines include the evaluation of evidence for diagnostic and therapeutic procedures in managing chronic spinal pain and recommendations for managing spinal pain are described here to provide recommendations for clinicians.
Journal ArticleDOI
The molecular basis of intervertebral disc degeneration.
Christopher K. Kepler,Ravi K. Ponnappan,Chadi Tannoury,Makarand V. Risbud,David Greg Anderson +4 more
TL;DR: It is suggested that genetic factors account for up to 75% of individual susceptibility to IVD degeneration, far more than the environmental factors such as occupational exposure or smoking that were previously suspected to figure prominently in this process.
Journal ArticleDOI
Exhaustion of nucleus pulposus progenitor cells with ageing and degeneration of the intervertebral disc
Daisuke Sakai,Yoshihiko Nakamura,Tomoko Nakai,Taishi Mishima,Shunichi Kato,Sibylle Grad,Mauro Alini,Makarand V. Risbud,Danny Chan,Kathryn S.E. Cheah,Ken Ichi Yamamura,Koichi Masuda,Hideyuki Okano,Kiyoshi Ando,Joji Mochida +14 more
TL;DR: In this article, the authors identify populations of progenitor cells that are Tie2 positive (Tie2+) and disialoganglioside 2 positive (GD2+), in the nucleus pulposus from mice and humans.
Journal ArticleDOI
Cell death in intervertebral disc degeneration
TL;DR: It is concluded that different stimuli induce cell death in IVD via various signal transduction pathways, and that cell death may play a key role in the degenerative process of IVD.
References
More filters
Journal ArticleDOI
Classification of age-related changes in lumbar intervertebral discs: 2002 Volvo Award in basic science.
Norbert Boos,Sabine Weissbach,Helmut Rohrbach,Christoph Weiler,Kevin F. Spratt,Andreas G. Nerlich +5 more
TL;DR: 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.
Journal ArticleDOI
Investigation of the laminate structure of lumbar disc anulus fibrosus.
Fran Oise Marchand,A. M. Ahmed +1 more
TL;DR: The structure of the lumbar disc anulus fibrosus was investigated using a layer-by-layer peeling technique and microscopic examination of various cut surfaces to identify mechanisms of layer interruption at local laminate irregularities.
Journal ArticleDOI
Matrix metalloproteinases and aggrecanase: Their role in disorders of the human intervertebral disc
TL;DR: In this paper, a comprehensive immunohistochemical study of matrix metalloproteinase activity in discs from patients with different disc diseases was conducted, and the most extensive staining was seen for matrix metallo-phrase 1, 2, 3, 7, 8, 9 and 13, with 91, 71, 65, and 72% of samples having some immunopositivity for the respective antibodies.
Journal ArticleDOI
Nerve growth factor expression and innervation of the painful intervertebral disc
Anthony J. Freemont,A. Watkins,C L Le Maitre,Pauline Baird,Maria Jeziorska,M. Knight,E. R. S. Ross,J. O’Brien,Judith A. Hoyland +8 more
TL;DR: Findings show that nociceptive nerve ingrowth into painful IVD is causally linked with NGF production by blood vessels growing into the IVD, from adjacent vertebral bodies.
Journal ArticleDOI
Analysis of aging and degeneration of the human intervertebral disc : Comparison of surgical specimens with normal controls
Helen E. Gruber,Edward N. Hanley +1 more
TL;DR: The findings reveal that there is a high incidence of apoptosis in the intervertebral disc and the identification of tartrate‐resistant acid phosphatase activity in disc cells allows for a new area of study of disc extracellular matrix remodelling.