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Narrative Review

Healing of painful intervertebral discs: implications for physiotherapy

Part 1 — the basic science of intervertebral discs healing

, &
Pages 234-240 | Published online: 12 Nov 2013

References

  • Badley EM, Tennant A. Changing profile of joint disorders with age: findings from a postal survey of the population of Calderdale, West Yorkshire, United Kingdom. Ann Rheum Dis. 1992;51(3):366–71.
  • Maniadakis N, Gray A. The economic burden of back pain in the UK. Pain. 2000;84(1):95–103.
  • Enthoven P, Skargren E, Oberg B. Clinical course in patients seeking primary care for back or neck pain: a prospective 5-year follow-up of outcome and health care consumption with subgroup analysis. Spine. 2004;29(21):2458–65.
  • Linton S, Ryberg M. Do epidemiological results replicate? The prevalence and health-economic consequences of neck and back pain in the general population. Eur J Pain. 2000;4(4):347–54.
  • Linton SJ, Hellsing AL, Hallden K. A population-based study of spinal pain among 35-45-year-old individuals. Prevalence, sick leave, and health care use. Spine. 1998;23(13):1457–63.
  • Boden SD, Davis DO, Dina TS, Patronas NJ, Wiesel SW. Abnormal magnetic-resonance scans of the lumbar spine in asymptomatic subjects. A prospective investigation. J Bone Joint Surg Am. 1990;72(3):403–8.
  • Jensen MC, Brant-Zawadzki MN, Obuchowski N, Modic MT, Malkasian D, Ross JS. Magnetic resonance imaging of the lumbar spine in people without back pain. N Engl J Med. 1994;331(2):69–73.
  • Bendix T, Kjaer P, Korsholm L. Burned-out discs stop hurting: fact or fiction? Spine. 2008;33(25):E962–7.
  • Cheung KM, Karppinen J, Chan D, Ho DW, Song YQ, Sham P, et al.. Prevalence and pattern of lumbar magnetic resonance imaging changes in a population study of one thousand forty-three individuals. Spine. 2009;34(9):934–40.
  • de Schepper EI, Damen J, van Meurs JB, Ginai AZ, Popham M, Hofman A, et al.. The association between lumbar disc degeneration and low back pain: the influence of age, gender, and individual radiographic features. Spine. 2010;35(5):531–6.
  • Videman T, Battie MC, Gibbons LE, Maravilla K, Manninen H, Kaprio J. Associations between back pain history and lumbar MRI findings. Spine. 2003;28(6):582–8.
  • Kuslich SD, Ulstrom CL, Michael CJ. 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. Orthop Clin North Am. 1991;22(2):181–7.
  • Hassler O. The human intervertebral disc. A micro-angiographical study on its vascular supply at various ages. Acta Orthopaedica Scandinavica. 1969;40(6):765–72.
  • Boos N, Weissbach S, Rohrbach H, Weiler C, Spratt KF, Nerlich AG. Classification of age-related changes in lumbar intervertebral discs: 2002 Volvo Award in basic science. Spine. 2002;27(23):2631–44.
  • Liebscher T, Haefeli M, Wuertz K, Nerlich AG, Boos N. Age-related variation in cell density of human lumbar intervertebral disc. Spine. 2011;36(2):153–9.
  • Guehring T, Urban JP, Cui Z, Tirlapur UK. Noninvasive 3D vital imaging and characterization of notochordal cells of the intervertebral disc by femtosecond near-infrared two-photon laser scanning microscopy and spatial-volume rendering. Microsc Res Tech. 2008;71(4):298–304.
  • Cappello R, Bird JL, Pfeiffer D, Bayliss MT, Dudhia J. Notochordal cell produce and assemble extracellular matrix in a distinct manner, which may be responsible for the maintenance of healthy nucleus pulposus. Spine. 2006;31(8):873–82 ; discussion 83.
  • Antoniou J, Steffen T, Nelson F, Winterbottom N, Hollander AP, Poole RA, et al.. The human lumbar intervertebral disc: evidence for changes in the biosynthesis and denaturation of the extracellular matrix with growth, maturation, ageing, and degeneration. J Clin Invest. 1996;98(4):996–1003.
  • Scott JE, Bosworth TR, Cribb AM, Taylor JR. The chemical morphology of age-related changes in human intervertebral disc glycosaminoglycans from cervical, thoracic and lumbar nucleus pulposus and annulus fibrosus. J Anat. 1994;184(Pt 1):73–82.
  • Taylor TK, Melrose J, Burkhardt D, Ghosh P, Claes LE, Kettler A, et al.. Spinal biomechanics and aging are major determinants of the proteoglycan metabolism of intervertebral disc cells. Spine. 2000;25(23):3014–20.
  • Urban JP, McMullin JF. Swelling pressure of the lumbar intervertebral discs: influence of age, spinal level, composition, and degeneration. Spine. 1988;13(2):179–87.
  • Bayliss MT, Johnstone B, O’Brien JP. 1988 Volvo award in basic science. Proteoglycan synthesis in the human intervertebral disc. Variation with age, region and pathology. Spine. 1988;13(9):972–81.
  • Antoniou J, Goudsouzian NM, Heathfield TF, Winterbottom N, Steffen T, Poole AR, et al.. The human lumbar endplate. Evidence of changes in biosynthesis and denaturation of the extracellular matrix with growth, maturation, aging, and degeneration. Spine. 1996;21(10):1153–61.
  • Eisenstein S, Roberts S. The physiology of the disc and its clinical relevance. J Bone Joint Surg Br. 2003 Jul;85(5):633–6.
  • Adams MA, McNally DS, Dolan P. ‘Stress’ distributions inside intervertebral discs. The effects of age and degeneration. J Bone Joint Surg Br. 1996;78(6):965–72.
  • Adams MA, McMillan DW, Green TP, Dolan P. Sustained loading generates stress concentrations in lumbar intervertebral discs. Spine. 1996;21(4):434–8.
  • Skrzypiec DM, Pollintine P, Przybyla A, Dolan P, Adams MA. The internal mechanical properties of cervical intervertebral discs as revealed by stress profilometry. Eur Spine J. 2007;16(10):1701–9.
  • Adams MA, Pollintine P, Tobias JH, Wakley GK, Dolan P. Intervertebral disc degeneration can predispose to anterior vertebral fractures in the thoracolumbar spine. J Bone Miner Res. 2006;21(9):1409–16.
  • Brown KR, Pollintine P, Adams MA. Biomechanical implications of degenerative joint disease in the apophyseal joints of human thoracic and lumbar vertebrae. American Journal of Physical Anthropology. 2008;136(3):318–26.
  • Pollintine P, Dolan P, Tobias JH, Adams MA. Intervertebral disc degeneration can lead to ‘stress-shielding’ of the anterior vertebral body: a cause of osteoporotic vertebral fracture? Spine. 2004;29(7):774–82.
  • Pollintine P, Przybyla AS, Dolan P, Adams MA. Neural arch load-bearing in old and degenerated spines. J Biomech. 2004;37(2):197–204.
  • Schollmeier G, Lahr-Eigen R, Lewandrowski KU. Observations on fiber-forming collagens in the anulus fibrosus. Spine. 2000;25(21):2736–41.
  • Pokharna HK, Phillips FM. Collagen crosslinks in human lumbar intervertebral disc aging. Spine. 1998;23(15):1645–8.
  • Iatridis JC, Setton LA, Weidenbaum M, Mow VC. Alterations in the mechanical behavior of the human lumbar nucleus pulposus with degeneration and aging. J Orthop Res. 1997;15(2):318–22.
  • Urban JP, Roberts S, Ralphs JR. The nucleus of the intervertebral disc from development to degeneration. Am Zool. 2000;40:53–61.
  • DeGroot J, Verzijl N, Wijk Wenting-VanMJ, Jacobs KM, El VanB, Roermund VanPM, et al.. Accumulation of advanced glycation end products as a molecular mechanism for aging as a risk factor in osteoarthritis. Arthritis Rheum. 2004;50(4):1207–15.
  • Maroudas A, Stockwell RA, Nachemson A, Urban J. Factors involved in the nutrition of the human lumbar intervertebral disc: cellularity and diffusion of glucose in vitro. J Anat. 1975;120(1):113–30.
  • Ferguson SJ, Ito K, Nolte LP. Fluid flow and convective transport of solutes within the intervertebral disc. J Biomech. 2004;37(2):213–21.
  • Coventry MB, Ghormley RK, Kernohan JW. The intervertebral disc: Its microscopic anatomy and pathology; anatomy, development and physiology. Part 1. J Bone Joint Surg Am. 1945;27:105–12.
  • Oda J, Tanaka H, Tsuzuki N. Intervertebral disc changes with aging of human cervical vertebra. From the neonate to the eighties. Spine. 1988;13(11):1205–11.
  • Benneker LM, Heini PF, Alini M, Anderson SE, Ito K. 2004 Young Investigator Award Winner: vertebral endplate marrow contact channel occlusions and intervertebral disc degeneration. Spine. 2005;30(2):167–73.
  • Rodriguez AG, Slichter CK, Acosta FL, Rodriguez-Soto AE, Burghardt AJ, Majumdar S, et al.. Human disc nucleus properties and vertebral endplate permeability. Spine. 20111;36(7):512–20.
  • Hee HT, Chuah YJ, Tan BH, Setiobudi T, Wong HK. Vascularization and morphological changes of the endplate after axial compression and distraction of the intervertebral disc. Spine. 2011;36(7):505–11.
  • Haefeli M, Kalberer F, Saegesser D, Nerlich AG, Boos N, Paesold G. The course of macroscopic degeneration in the human lumbar intervertebral disc. Spine. 2006;31(14):1522–31.
  • Barrie Vernon-Roberts, Moore RJ, Fraser RD. The natural history of age-related disc degeneration: the pathology and sequelae of tears. Spine. 2007;32(25):2797–2804.
  • Pearcy M, Portek I, Shepherd J. Three-dimensional x-ray analysis of normal movement in the lumbar spine. Spine. 1984;9(3):294–7.
  • Adams MA, Freeman BJ, Morrison HP, Nelson IW, Dolan P. Mechanical initiation of intervertebral disc degeneration. Spine. 2000;25(13):1625–36.
  • Brinckmann P, Horst M. The influence of vertebral body fracture, intradiscal injection, and partial discectomy on the radial bulge and height of human lumbar discs. Spine. 1985;10(2):138–45.
  • Adams MA, Hutton WC. Prolapsed intervertebral disc. A hyperflexion injury 1981 Volvo Award in Basic Science. Spine. 1982;7(3):184–91.
  • Veres SP, Robertson PA, Broom ND. ISSLS prize winner: microstructure and mechanical disruption of the lumbar disc annulus: part II: how the annulus fails under hydrostatic pressure. Spine. 2008;33(25):2711–20.
  • Adams MA, Hutton WC. Gradual disc prolapse. Spine. 1985;10(6):524–31.
  • Adams MA, Hutton WC. The relevance of torsion to the mechanical derangement of the lumbar spine. Spine. 1981;6(3):241–8.
  • Schmidt H, Kettler A, Rohlmann A, Claes L, Wilke HJ. The risk of disc prolapses with complex loading in different degrees of disc degeneration — a finite element analysis. Clin Biomech (Bristol, Avon). 2007;22(9):988–98.
  • Holm S, Holm AK, Ekstrom L, Karladani A, Hansson T. Experimental disc degeneration due to endplate injury. J Spinal Disord Tech. 2004;17(1):64–71.
  • Osti OL, Vernon-Roberts B, Fraser RD. 1990 Volvo Award in experimental studies. Anulus tears and intervertebral disc degeneration. An experimental study using an animal model. Spine. 1990;15(8):762–7.
  • Ulrich JA, Liebenberg EC, Thuillier DU, Lotz JC. ISSLS prize winner: repeated disc injury causes persistent inflammation. Spine. 2007;32(25):2812–9.
  • Videman T, Levalahti E, Battie MC. The effects of anthropometrics, lifting strength, and physical activities in disc degeneration. Spine. 2007;32(13):1406–13.
  • Videman T, Sarna S, Battie MC, Koskinen S, Gill K, Paananen H, et al.. The long-term effects of physical loading and exercise lifestyles on back-related symptoms, disability, and spinal pathology among men. Spine. 1995;20(6):699–709.
  • Handa T, Ishihara H, Ohshima H, Osada R, Tsuji H, Obata K. Effects of hydrostatic pressure on matrix synthesis and matrix metalloproteinase production in the human lumbar intervertebral disc. Spine. 1997;22(10):1085–91.
  • Ishihara H, McNally DS, Urban JP, Hall AC. Effects of hydrostatic pressure on matrix synthesis in different regions of the intervertebral disk. J Appl Physiol. 1996;80(3):839–46.
  • Skrzypiec D, Tarala M, Pollintine P, Dolan P, Adams MA. When are intervertebral discs stronger than their adjacent vertebrae? Spine. 2007;32(22):2455–61.
  • Hastreiter D, Ozuna RM, Spector M. Regional variations in certain cellular characteristics in human lumbar intervertebral discs, including the presence of alpha-smooth muscle actin. J Orthop Res. 2001;19(4):597–604.
  • Zito G, Jull G, Story I. Clinical tests of musculoskeletal dysfunction in the diagnosis of cervicogenic headache. Man Ther. 2006;11(2):118–29.
  • Moneta GB, Videman T, Kaivanto K, Aprill C, Spivey M, Vanharanta H, et al.. Reported pain during lumbar discography as a function of anular ruptures and disc degeneration. A re-analysis of 833 discograms. Spine. 1994;19(17):1968–74.
  • Videman T, Nurminen M. The occurrence of anular tears and their relation to lifetime back pain history: a cadaveric study using barium sulfate discography. Spine. 2004;29(23):2668–76.
  • Peng B, Hou S, Wu W, Zhang C, Yang Y. The pathogenesis and clinical significance of a high-intensity zone (HIZ) of lumbar intervertebral disc on MR imaging in the patient with discogenic low back pain. Eur Spine J. 2006;15(5):583–7.
  • Peng B, Chen J, Kuang Z, Li D, Pang X, Zhang X. Diagnosis and surgical treatment of back pain originating from endplate. Eur Spine J. 2009;18(7):1035–40.
  • Boos N, Rieder R, Schade V, Spratt KF, Semmer N, Aebi M. 1995 Volvo Award in clinical sciences. The diagnostic accuracy of magnetic resonance imaging, work perception, and psychosocial factors in identifying symptomatic disc herniations. Spine. 1995;20(24):2613–25.
  • Bogduk N, Tynan W, Wilson AS. The nerve supply to the human lumbar intervertebral discs. J Anat. 1981;132(Pt 1):39–56.
  • Cavanaugh JM, Kallakuri S, Ozaktay AC. Innervation of the rabbit lumbar intervertebral disc and posterior longitudinal ligament. Spine. 1995;20(19):2080–5.
  • Fagan A, Moore R, Roberts VernonB, Blumbergs P, Fraser R. ISSLS Prize Winner: The innervation of the intervertebral disc: a quantitative analysis. Spine. 2003;28(23):2570–6.
  • Suseki K, Takahashi Y, Takahashi K, Chiba T, Yamagata M, Moriya H. Sensory nerve fibres from lumbar intervertebral discs pass through rami communicantes. A possible pathway for discogenic low back pain. J Bone Joint Surg Br. 1998;80(4):737–42.
  • Takebayashi T, Cavanaugh JM, Kallakuri S, Chen C, Yamashita T. Sympathetic afferent units from lumbar intervertebral discs. J Bone Joint Surg Br. 2006;88(4):554–7.
  • Ohtori S, Takahashi Y, Takahashi K, Yamagata M, Chiba T, Tanaka K, et al.. Sensory innervation of the dorsal portion of the lumbar intervertebral disc in rats. Spine. 1999;24(22):2295–9.
  • Yamashita T, Minaki Y, Oota I, Yokogushi K, Ishii S. Mechanosensitive afferent units in the lumbar intervertebral disc and adjacent muscle. Spine. 1993;18(15):2252–6.
  • Konttinen YT, Gronblad M, Antti-Poika I, Seitsalo S, Santavirta S, Hukkanen M, et al.. Neuroimmunohistochemical analysis of peridiscal nociceptive neural elements. Spine. 1990;15(5):383–6.
  • Palmgren T, Gronblad M, Virri J, Kaapa E, Karaharju E. An immunohistochemical study of nerve structures in the anulus fibrosus of human normal lumbar intervertebral discs. Spine. 1999;24(20):2075–9.
  • Mercer S, Bogduk N. The ligaments and annulus fibrosus of human adult cervical intervertebral discs. Spine. 1999;24(7):619–26 ; discussion 27–8.
  • Jackson HC, Winkelmann RK, Bickel WH. Nerve endings in the human lumbar spinal column and related structures. J Bone Joint Surg Am. 1966;48(7):1272–81.
  • Ashton IK, Roberts S, Jaffray DC, Polak JM, Eisenstein SM. Neuropeptides in the human intervertebral disc. J Orthop Res. 1994;12(2):186–92.
  • Brown MF, Hukkanen MV, McCarthy ID, Redfern DR, Batten JJ, Crock HV, et al.. Sensory and sympathetic innervation of the vertebral endplate in patients with degenerative disc disease. J Bone Joint Surg Br. 1997;79(1):147–53.
  • Ozawa T, Ohtori S, Inoue G, Aoki Y, Moriya H, Takahashi K. The degenerated lumbar intervertebral disc is innervated primarily by peptide-containing sensory nerve fibers in humans. Spine. 2006;31(21):2418–22.
  • Palmgren T, Gronblad M, Virri J, Seitsalo S, Ruuskanen M, Karaharju E. Immunohistochemical demonstration of sensory and autonomic nerve terminals in herniated lumbar disc tissue. Spine. 1996;21(11):1301–6.
  • Kojima Y, Maeda T, Arai R, Shichikawa K. Nerve supply to the posterior longitudinal ligament and the intervertebral disc of the rat vertebral column as studied by acetylcholinesterase histochemistry. I. Distribution in the lumbar region. J Anat. 1990;169:237–46.
  • Forsythe WB, Ghoshal NG. Innervation of the canine thoracolumbar vertebral column. Anat Rec. 1984;208(1):57–63.
  • Freemont AJ, Peacock TE, Goupille P, Hoyland JA, O’Brien J, Jayson MI. Nerve ingrowth into diseased intervertebral disc in chronic back pain. Lancet. 1997;350(9072):178–81.
  • Peng B, Wu W, Hou S, Li P, Zhang C, Yang Y. The pathogenesis of discogenic low back pain. J Bone Joint Surg Br. 2005;87(1):62–7.
  • Dongfeng R, Hou S, Wu W, Wang H, Shang W, Tang J, et al.. The Expression of tumor necrosis factor-alpha and CD68 in high-intensity zone of lumbar intervertebral disc on magnetic resonance image in the patients with low back pain. Spine. 2011;36(6):E429–33.
  • Peng B, Hao J, Hou S, Wu W, Jiang D, Fu X, et al.. Possible pathogenesis of painful intervertebral disc degeneration. Spine. 2006;31(5):560–6.
  • Johnson WE, Caterson B, Eisenstein SM, Hynds DL, Snow DM, Roberts S. Human intervertebral disc aggrecan inhibits nerve growth in vitro. Arthritis Rheum. 2002;46(10):2658–64.
  • Johnson WE, Caterson B, Eisenstein SM, Roberts S. Human intervertebral disc aggrecan inhibits endothelial cell adhesion and cell migration in vitro. Spine. 2005;30(10):1139–47.
  • Chen C, Cavanaugh JM, Song Z, Takebayashi T, Kallakuri S, Wooley PH. Effects of nucleus pulposus on nerve root neural activity, mechanosensitivity, axonal morphology, and sodium channel expression. Spine. 2004;29(1):17–25.
  • Goupille P, Mulleman D, Paintaud G, Watier H, Valat JP. Can sciatica induced by disc herniation be treated with tumor necrosis factor alpha blockade? Arthritis Rheum. 2007;56(12):3887–95.
  • Olmarker K, Iwabuchi M, Larsson K, Rydevik B. Walking analysis of rats subjected to experimental disc herniation. Eur Spine J. 1998;7(5):394–9.
  • Kayama S, Konno S, Olmarker K, Yabuki S, Kikuchi S. Incision of the anulus fibrosus induces nerve root morphologic, vascular, and functional changes. An experimental study. Spine. 1996;21(22):2539–43.
  • Olmarker K. Puncture of a lumbar intervertebral disc induces changes in spontaneous pain behavior: an experimental study in rats. Spine. 2008;33(8):850–5.
  • Sato K, Kikuchi S, Yonezawa T. In vivo intradiscal pressure measurement in healthy individuals and in patients with ongoing back problems. Spine. 1999;24(23):2468–74.
  • McNally DS, Shackleford IM, Goodship AE, Mulholland RC. In vivo stress measurement can predict pain on discography. Spine. 1996;21(22):2580–7.
  • Adams MA, Bogduk N, Burton K, Dolan P. The biomechanics of back pain. 2nd ed. Edinburgh: Churchill Livingstone; 2006.
  • Melzack R, Wall PD. The challenge of pain. Middlesex: Penguin Books; 1982.
  • Burke JG, Watson RW, McCormack D, Dowling FE, Walsh MG, Fitzpatrick JM. Intervertebral discs which cause low back pain secrete high levels of proinflammatory mediators. J Bone Joint Surg Br. 2002;84(2):196–201.
  • Schaible HG, Schmidt RF. Effects of an experimental arthritis on the sensory properties of fine articular afferent units. J Neurophysiol. 1985;54(5):1109–22.
  • Siddall PJ, Cousins MJ. Spinal pain mechanisms. Spine. 1997;22(1):98–104.

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