Degenerative Disc Disease of the Spine: From Anatomy to Pathophysiology and Radiological Appearance, with Morphological and Functional Considerations

Overview

Journal J Pers Med

Date 2022 Dec 29

PMID 36579533

Authors

Luca Scarcia

Marco Pileggi

Arianna Camilli

Andrea Romi

Andrea Bartolo

Francesca Giubbolini

Iacopo Valente

Giuseppe Garignano

Francesco DArgento

Alessandro Pedicelli

Andrea Maria Alexandre

Affiliations

Soon will be listed here.

Abstract

Degenerative disc disease is a common manifestation in routine imaging of the spine; this finding is partly attributable to physiological aging and partly to a pathological condition, and sometimes this distinction is simply not clear. In this review, we start focusing on disc anatomy and pathophysiology and try to correlate them with radiological aspects. Furthermore, there is a special focus on degenerative disc disease terminology, and, finally, some considerations regarding disc morphology and its specific function, as well as the way in which these aspects change in degenerative disease. Radiologists, clinicians and spine surgeons should be familiar with these aspects since they have an impact on everyday clinical practice.

Citing Articles

A framework of biomarkers for skeletal aging: a consensus statement by the Aging Biomarker Consortium.

Suo J, Gan Y, Xie Y, Xu S, Wang J, Chen D Life Med. 2025; 2(6):lnad045.

PMID: 39872060 PMC: 11748998. DOI: 10.1093/lifemedi/lnad045.

The Decline of Lumbar Artificial Disc Replacement.

Eskandar T, Ahmed Z, Pan J, Agrawal D J Spine Res Surg. 2024; 6(3):86-92.

PMID: 39267915 PMC: 11392031. DOI: 10.26502/fjsrs0078.

Tomographic Assessment of Fusion Rate, Implant-Endplate Contact Area, Subsidence, and Alignment With Lumbar Personalized Interbody Implants at 1-Year Follow-Up.

Ames C, Smith J, Nicolau R Int J Spine Surg. 2024; 18(S1):S41-S49.

PMID: 39191476 PMC: 11483439. DOI: 10.14444/8640.

The Invasive Management of Pain: Diagnosis and New Treatment Options.

Mayoral Rojals V, Amescua Garcia C, Denegri P, Narvaez Tamayo M, Varrassi G Cureus. 2023; 15(7):e42717.

PMID: 37654942 PMC: 10466260. DOI: 10.7759/cureus.42717.

Exploring the latest advancements in physical therapy techniques for treating cervical spondylosis patients: A narrative review.

Chen Q, Wang Z, Zhang S Biomol Biomed. 2023; 23(5):752-759.

PMID: 37212037 PMC: 10494843. DOI: 10.17305/bb.2023.9049.

References

Altun I . Cytokine profile in degenerated painful intervertebral disc: variability with respect to duration of symptoms and type of disease. Spine J. 2016; 16(7):857-61. DOI: 10.1016/j.spinee.2016.03.019. View

Horner H, Urban J . 2001 Volvo Award Winner in Basic Science Studies: Effect of nutrient supply on the viability of cells from the nucleus pulposus of the intervertebral disc. Spine (Phila Pa 1976). 2001; 26(23):2543-9. DOI: 10.1097/00007632-200112010-00006. View

Newell N, Carpanen D, Evans J, Pearcy M, Masouros S . Mechanical Function of the Nucleus Pulposus of the Intervertebral Disc Under High Rates of Loading. Spine (Phila Pa 1976). 2019; 44(15):1035-1041. DOI: 10.1097/BRS.0000000000003092. View

Krock E, Currie J, Weber M, Ouellet J, S Stone L, Rosenzweig D . Nerve Growth Factor Is Regulated by Toll-Like Receptor 2 in Human Intervertebral Discs. J Biol Chem. 2015; 291(7):3541-51. PMC: 4751394. DOI: 10.1074/jbc.M115.675900. View

Sadowska A, Touli E, Hitzl W, Greutert H, Ferguson S, Wuertz-Kozak K . Inflammaging in cervical and lumbar degenerated intervertebral discs: analysis of proinflammatory cytokine and TRP channel expression. Eur Spine J. 2017; 27(3):564-577. DOI: 10.1007/s00586-017-5360-8. View

Chedid K, Chedid M . The "tract" of history in the treatment of lumbar degenerative disc disease. Neurosurg Focus. 2004; 16(1):E7. DOI: 10.3171/foc.2004.16.1.8. View

Silagi E, Shapiro I, Risbud M . Glycosaminoglycan synthesis in the nucleus pulposus: Dysregulation and the pathogenesis of disc degeneration. Matrix Biol. 2018; 71-72:368-379. PMC: 6119535. DOI: 10.1016/j.matbio.2018.02.025. View

Griffith J, Wang Y, Antonio G, Choi K, Yu A, Ahuja A . Modified Pfirrmann grading system for lumbar intervertebral disc degeneration. Spine (Phila Pa 1976). 2007; 32(24):E708-12. DOI: 10.1097/BRS.0b013e31815a59a0. View

Ghezelbash F, Eskandari A, Shirazi-Adl A, Kazempour M, Tavakoli J, Baghani M . Modeling of human intervertebral disc annulus fibrosus with complex multi-fiber networks. Acta Biomater. 2021; 123:208-221. DOI: 10.1016/j.actbio.2020.12.062. View

10.

Clarencon F, Law-Ye B, Bienvenot P, Cormier E, Chiras J . The Degenerative Spine. Magn Reson Imaging Clin N Am. 2016; 24(3):495-513. DOI: 10.1016/j.mric.2016.04.008. View

11.

Colombini A, Lombardi G, Marco Corsi M, Banfi G . Pathophysiology of the human intervertebral disc. Int J Biochem Cell Biol. 2008; 40(5):837-42. DOI: 10.1016/j.biocel.2007.12.011. View

12.

Pope M . Biomechanics of the lumbar spine. Ann Med. 1989; 21(5):347-51. DOI: 10.3109/07853898909149219. View

13.

Teraguchi M, Yoshimura N, Hashizume H, Yamada H, Oka H, Minamide A . Progression, incidence, and risk factors for intervertebral disc degeneration in a longitudinal population-based cohort: the Wakayama Spine Study. Osteoarthritis Cartilage. 2017; 25(7):1122-1131. DOI: 10.1016/j.joca.2017.01.001. View

14.

Schmidt H, Shirazi-Adl A . Temporal and spatial variations of pressure within intervertebral disc nuclei. J Mech Behav Biomed Mater. 2018; 79:309-313. DOI: 10.1016/j.jmbbm.2018.01.012. View

15.

Dowdell J, Erwin M, Choma T, Vaccaro A, Iatridis J, Cho S . Intervertebral Disk Degeneration and Repair. Neurosurgery. 2017; 80(3S):S46-S54. PMC: 5585783. DOI: 10.1093/neuros/nyw078. View

16.

Virk S, Meyers K, Lafage V, Maher S, Chen T . Analysis of the influence of species, intervertebral disc height and Pfirrmann classification on failure load of an injured disc using a novel disc herniation model. Spine J. 2020; 21(4):698-707. DOI: 10.1016/j.spinee.2020.10.030. View

17.

Thompson J, PEARCE R, Schechter M, Adams M, Tsang I, Bishop P . Preliminary evaluation of a scheme for grading the gross morphology of the human intervertebral disc. Spine (Phila Pa 1976). 1990; 15(5):411-5. DOI: 10.1097/00007632-199005000-00012. View

18.

Patwardhan R, Hadley M . History of surgery for ruptured disk. Neurosurg Clin N Am. 2001; 12(1):173-9, x. View

19.

Khan A, Jacobsen H, Khan J, Filippi C, Levine M, Lehman Jr R . Inflammatory biomarkers of low back pain and disc degeneration: a review. Ann N Y Acad Sci. 2017; 1410(1):68-84. PMC: 5744892. DOI: 10.1111/nyas.13551. View

20.

Jones K, Unger E, Granstrom P, Seeger J, Carmody R, Yoshino M . Bone marrow imaging using STIR at 0.5 and 1.5 T. Magn Reson Imaging. 1992; 10(2):169-76. DOI: 10.1016/0730-725x(92)90477-h. View