Intervertebral Disc Degeneration-Current Therapeutic Options and Challenges

Overview

Journal Front Public Health

Specialty Public Health

Date 2023 Jul 24

PMID 37483952

Authors

Ankita Samanta

Thomas Lufkin

Petra Kraus

Affiliations

Soon will be listed here.

Abstract

Degeneration of the intervertebral disc (IVD) is a normal part of aging. Due to the spine's declining function and the development of pain, it may affect one's physical health, mental health, and socioeconomic status. Most of the intervertebral disc degeneration (IVDD) therapies today focus on the symptoms of low back pain rather than the underlying etiology or mechanical function of the disc. The deteriorated disc is typically not restored by conservative or surgical therapies that largely focus on correcting symptoms and structural abnormalities. To enhance the clinical outcome and the quality of life of a patient, several therapeutic modalities have been created. In this review, we discuss genetic and environmental causes of IVDD and describe promising modern endogenous and exogenous therapeutic approaches including their applicability and relevance to the degeneration process.

Citing Articles

Gallic acid protects intervertebral disc cells from ferroptosis and alleviates intervertebral disc degeneration by regulating key factors of oxidative stress.

Zhu Z, Huang Z, Zhang C, Xu B, Chen H, Pei S Front Pharmacol. 2025; 16:1501725.

PMID: 39963245 PMC: 11830718. DOI: 10.3389/fphar.2025.1501725.

Pyroptosis: candidate key targets for mesenchymal stem cell-derived exosomes for the treatment of bone-related diseases.

Li H, Zhang P, Lin M, Li K, Zhang C, He X Stem Cell Res Ther. 2025; 16(1):68.

PMID: 39940049 PMC: 11816542. DOI: 10.1186/s13287-025-04167-y.

Innovating intervertebral disc degeneration therapy: Harnessing the power of extracellular vesicles.

Chen S, Dou Y, Zhang Y, Sun X, Liu X, Yang Q J Orthop Translat. 2025; 50:44-55.

PMID: 39868351 PMC: 11761297. DOI: 10.1016/j.jot.2024.09.014.

Targeting nucleus pulposus cell death in the treatment of intervertebral disc degeneration.

Sun H, Guo J, Xiong Z, Zhuang Y, Ning X, Liu M JOR Spine. 2024; 7(4):e70011.

PMID: 39703198 PMC: 11655182. DOI: 10.1002/jsp2.70011.

Alginate vs. Hyaluronic Acid as Carriers for Nucleus Pulposus Cells: A Study on Regenerative Outcomes in Disc Degeneration.

Ogasawara S, Schol J, Sakai D, Warita T, Susumu T, Nakamura Y Cells. 2024; 13(23).

PMID: 39682732 PMC: 11639827. DOI: 10.3390/cells13231984.

References

Varden L, Nguyen D, Michalek A . Slow depressurization following intradiscal injection leads to injectate leakage in a large animal model. JOR Spine. 2019; 2(3):e1061. PMC: 6764785. DOI: 10.1002/jsp2.1061. View

Risbud M, Guttapalli A, Tsai T, Lee J, Danielson K, Vaccaro A . Evidence for skeletal progenitor cells in the degenerate human intervertebral disc. Spine (Phila Pa 1976). 2007; 32(23):2537-44. DOI: 10.1097/BRS.0b013e318158dea6. View

Berman D, Oren J, Bendo J, Spivak J . The Effect of Smoking on Spinal Fusion. Int J Spine Surg. 2018; 11:29. PMC: 5779238. DOI: 10.14444/4029. View

Nasto L, Ngo K, Leme A, Robinson A, Dong Q, Roughley P . Investigating the role of DNA damage in tobacco smoking-induced spine degeneration. Spine J. 2013; 14(3):416-23. PMC: 3944725. DOI: 10.1016/j.spinee.2013.08.034. View

Chen F, Jiang G, Liu H, Li Z, Pei Y, Wang H . Melatonin alleviates intervertebral disc degeneration by disrupting the IL-1β/NF-κB-NLRP3 inflammasome positive feedback loop. Bone Res. 2020; 8:10. PMC: 7028926. DOI: 10.1038/s41413-020-0087-2. View

Trout J, Buckwalter J, Moore K, Landas S . Ultrastructure of the human intervertebral disc. I. Changes in notochordal cells with age. Tissue Cell. 1982; 14(2):359-69. DOI: 10.1016/0040-8166(82)90033-7. View

Jayakumar R, Prabaharan M, Nair S, Tamura H . Novel chitin and chitosan nanofibers in biomedical applications. Biotechnol Adv. 2009; 28(1):142-50. DOI: 10.1016/j.biotechadv.2009.11.001. View

Rodova M, Lu Q, Li Y, Woodbury B, Crist J, Gardner B . Nfat1 regulates adult articular chondrocyte function through its age-dependent expression mediated by epigenetic histone methylation. J Bone Miner Res. 2011; 26(8):1974-86. PMC: 3353550. DOI: 10.1002/jbmr.397. View

Yuan F, Xu R, Ye J, Zhao M, Ren L, Li X . Apoptotic bodies from endplate chondrocytes enhance the oxidative stress-induced mineralization by regulating PPi metabolism. J Cell Mol Med. 2019; 23(5):3665-3675. PMC: 6484318. DOI: 10.1111/jcmm.14268. View

10.

Sivakamasundari V, Kraus P, Sun W, Hu X, Lim S, Prabhakar S . A developmental transcriptomic analysis of and in embryonic intervertebral disc development. Biol Open. 2016; 6(2):187-199. PMC: 5312110. DOI: 10.1242/bio.023218. View

11.

Li H, Li W, Liang B, Wei J, Yin D, Fan Q . Role of AP-2α/TGF-β1/Smad3 axis in rats with intervertebral disc degeneration. Life Sci. 2020; 263:118567. DOI: 10.1016/j.lfs.2020.118567. View

12.

Mertimo T, Karppinen J, Niinimaki J, Blanco R, Maatta J, Kankaanpaa M . Association of lumbar disc degeneration with low back pain in middle age in the Northern Finland Birth Cohort 1966. BMC Musculoskelet Disord. 2022; 23(1):359. PMC: 9011971. DOI: 10.1186/s12891-022-05302-z. View

13.

Sebastine I, Williams D . Current developments in tissue engineering of nucleus pulposus for the treatment of intervertebral disc degeneration. Annu Int Conf IEEE Eng Med Biol Soc. 2007; 2007:6401-6. DOI: 10.1109/IEMBS.2007.4353821. View

14.

Mohd Isa I, Teoh S, Mohd Nor N, Mokhtar S . Discogenic Low Back Pain: Anatomy, Pathophysiology and Treatments of Intervertebral Disc Degeneration. Int J Mol Sci. 2023; 24(1). PMC: 9820240. DOI: 10.3390/ijms24010208. View

15.

Iatridis J, Kang J, Kandel R, Risbud M . New horizons in spine research: Intervertebral disc repair and regeneration. J Orthop Res. 2017; 35(1):5-7. PMC: 5482231. DOI: 10.1002/jor.23499. View

16.

Seki S, Asanuma-Abe Y, Masuda K, Kawaguchi Y, Asanuma K, Muehleman C . Effect of small interference RNA (siRNA) for ADAMTS5 on intervertebral disc degeneration in the rabbit anular needle-puncture model. Arthritis Res Ther. 2009; 11(6):R166. PMC: 3003501. DOI: 10.1186/ar2851. View

17.

Zhu J, Xia K, Yu W, Wang Y, Hua J, Liu B . Sustained release of GDF5 from a designed coacervate attenuates disc degeneration in a rat model. Acta Biomater. 2019; 86:300-311. DOI: 10.1016/j.actbio.2019.01.028. View

18.

Recuerda M, Perie D, Gilbert G, Beaudoin G . Assessment of mechanical properties of isolated bovine intervertebral discs from multi-parametric magnetic resonance imaging. BMC Musculoskelet Disord. 2012; 13:195. PMC: 3565974. DOI: 10.1186/1471-2474-13-195. View

19.

Alba R, Bosch A, Chillon M . Gutless adenovirus: last-generation adenovirus for gene therapy. Gene Ther. 2005; 12 Suppl 1:S18-27. DOI: 10.1038/sj.gt.3302612. View

20.

Xia C, Zeng Z, Fang B, Tao M, Gu C, Zheng L . Mesenchymal stem cell-derived exosomes ameliorate intervertebral disc degeneration via anti-oxidant and anti-inflammatory effects. Free Radic Biol Med. 2019; 143:1-15. DOI: 10.1016/j.freeradbiomed.2019.07.026. View