Journal ArticleDOI
Mechanical Initiation of Intervertebral Disc Degeneration
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TLDR
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.Abstract:
volves gross structural disruption as well as cell-mediated changes in matrix composition, but there is little evidence concerning which comes first. Comparatively minor damage to a vertebral body is known to decompress the adjacent discs, and this may adversely affect both structure and cell function in the disc. Methods. In this study, 38 cadaveric lumbar motion segments (mean age, 51 years) were subjected to complex mechanical loading to simulate typical activities in vivo while the distribution of compressive stress in the disc matrix was measured using a pressure transducer mounted in a needle 1.3 mm in diameter. “Stress profiles” were repeated after a controlled compressive overload injury had reduced motion segment height by approximately 1%. Moderate repetitive loading, appropriate for the simulation of light manual labor, then was applied to the damaged specimens for approximately 4 hours, and stress profilometry was repeated a third time. Discs then were sectioned and photographed. Results. Endplate damage reduced pressure in the adjacent nucleus pulposus by 25% 6 27% and generated peaks of compressive stress in the anulus, usually posteriorly to the nucleus. Discs 50 to 70 years of age were affected the most. Repetitive loading further decompressed the nucleus and intensified stress concentrations in the anulus, especially in simulated lordotic postures. Sagittal plane sections of 15 of the discs showed an inwardly collapsing anulus in 9 discs, extreme outward bulging of the anulus in 11 discs, and complete radial fissures in 2 discs, 1 of which allowed posterior migration of nucleus pulposus. 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. Conclusions. Minor damage to a vertebral body endread more
Citations
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Reactive changes in the adolescent porcine spine with disc degeneration due to endplate injury.
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References
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Journal ArticleDOI
Aging and degeneration of the human intervertebral disc.
TL;DR: In this paper, the most important of these mechanisms appears to be decreasing nutrition of the central disc that allows accumulation of cell waste products and degraded matrix molecules, impairs cell nutrition, and causes a fall in pH levels that further compromises cell function and may cause cell death.
Journal ArticleDOI
Humeral hypertrophy in response to exercise.
TL;DR: Compared roentgenograms of the jumeri of a group of professional tennis players showed that there was pronounced hypertrophy of bone on the playing side, and the cortical thickness on that side was greater than the control side.
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The Prevalence and Clinical Features of Internal Disc Disruption in Patients With Chronic Low Back Pain
TL;DR: A diagnosis of internal disc disruption can be made in a significant proportion of patients with chronic low back pain, but no conventional clinical test can discriminate patients withinternal disc disruption from patients with other conditions.
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‘stress’ distributions inside intervertebral discs: the effects of age and degeneration
TL;DR: It is suggested that structural changes within the annulus and endplate lead to a transfer of load from the nucleus to the posterior annulus, and high 'stress' concentrations within the Annulus may cause pain, and lead to further disruption.
Journal ArticleDOI
The tissue origin of low back pain and sciatica: a report of pain response to tissue stimulation during operations on the lumbar spine using local anesthesia.
TL;DR: In an effort to define the origin of low back pain and sciatica, 193 patients were carefully studied using progressive local anesthesia and the results are discussed.