Techniques in Regional Anesthesia & Pain Management
Volume 13, Issue 2 , Pages 67-75 , April 2009

Anatomy and pathophysiology of intervertebral disc disease

  • Hariharan Shankar, MBBS

      Affiliations

    • Department of Anesthesiology, Clement Zablocki VA Medical Center, Milwaukee, Wisconsin
    • Department of Anesthesiology, Medical College of Wisconsin, Milwaukee, Wisconsin
    • Corresponding Author InformationAddress reprint requests and correspondence: Hariharan Shankar, MBBS, Department of Anesthesiology, Clement Zablocki VA Medical Center, 5000 West National Avenue, Milwaukee, WI 53295
  • ,
  • Jeremy A. Scarlett, MD

      Affiliations

    • Department of Anesthesiology, Medical College of Wisconsin, Milwaukee, Wisconsin
  • ,
  • Stephen E. Abram, MD

      Affiliations

    • Department of Anesthesiology, Medical College of Wisconsin, Milwaukee, Wisconsin

References 

  1. Boos N, Weissbach S, Rohrbach H, et al. Classification of age-related changes in lumbar intervertebral discs: 2002 Volvo award in basic science. Spine. 2002;27:2631–2644
  2. Miller JA, Schmatz C, Schultz AB. Lumbar disc degeneration: Correlation with age, sex, and spine level in 600 autopsy specimens. Spine. 1988;13:173–178
  3. Luoma K, Riihimaki H, Luukkonen R, et al. Low back pain in relation to lumbar disc degeneration. Spine. 2000;25:487–492
  4. Raj PP. Intervertebral disc: Anatomy-physiology-pathophysiology-treatment. Pain Pract. 2008;8:18–44
  5. Maniadakis N, Gray A. The economic burden of back pain in the UK. Pain. 2000;84:95–103
  6. Coventry MB, Ghormley RK, Kernohan JW. The intervertebral disc: Its microscopic anatomy and pathology. Part I. Anatomy, development, and physiology. J Bone Joint Surg Am. 1945;27:105–112
  7. Pye SR, Reid DM, Lunt M, et al. Lumbar disc degeneration: Association between osteophytes, end-plate sclerosis and disc space narrowing. Ann Rheum Dis. 2007;66:330–333
  8. Weishaupt D, Zanetti M, Hodler J, et al. Painful lumbar disk derangement: Relevance of endplate abnormalities at MR imaging. Radiology. 2001;218:420–427
  9. Edgar MA. The nerve supply of the lumbar intervertebral disc. J Bone Joint Surg Br. 2007;89:1135–1139
  10. Fagan A, Moore R, Vernon Roberts B, et al. The innervation of the intervertebral disc: A quantitative analysis. Spine. 2003;28:2570–2576
  11. Errington RJ, Puustjarvi K, White IR, et al. Characterization of cytoplasm-filled processes in cells of the intervertebral disc. J Anat. 1998;192:369–378
  12. Singh K, Masuda K, Thonar EJ, et al. Age-related changes in the extracellular matrix of nucleus pulposus and anulus fibrosus of human intervertebral disc. Spine. 2009;34:10–16
  13. Eyre DR, Matsui Y, Wu JJ. Collagen polymorphisms of the intervertebral disc. Biochem Soc Trans. 2002;30:844–848
  14. Johnson WE, Evans H, Menage J, et al. Immunohistochemical detection of Schwann cells in innervated and vascularized human intervertebral discs. Spine. 2001;26:2550–2557
  15. Rajasekaran S, Babu JN, Arun R, et al. ISSLS prize winner: A study of diffusion in human lumbar discs: A serial magnetic resonance imaging study documenting the influence of the endplate on diffusion in normal and degenerate discs. Spine. 2004;29:2654–2667
  16. Kealey SM, Aho T, Delong D, et al. Assessment of apparent diffusion coefficient in normal and degenerated intervertebral lumbar disks: Initial experience. Radiology. 2005;235:569–574
  17. Adams MA, Roughley PJ. What is intervertebral disc degeneration, and what causes it?. Spine. 2006;31:2151–2161
  18. Boos N, Wallin A, Aebi M, et al. A new magnetic resonance imaging analysis method for the measurement of disc height variations. Spine. 1996;21:563–570
  19. Roberts N, Hogg D, Whitehouse GH, et al. Quantitative analysis of diurnal variation in volume and water content of lumbar intervertebral discs. Clin Anat. 1998;11:1–8
  20. Karakida O, Ueda H, Ueda M, et al. Diurnal T2 value changes in the lumbar intervertebral discs. Clin Radiol. 2003;58:389–392
  21. Coventry MB, Ghormley RK, Kernohan JW. The intervertebral disc: Its microscopic anatomy and pathology. Part II. changes in the intervertebral disc concomitant with age. J Bone Joint Surg Am. 1945;27:233–237
  22. Horner HA, Urban JP. 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. 2001;26:2543–2549
  23. Modic MT, Ross JS. Lumbar degenerative disk disease. Radiology. 2007;245:43–61
  24. Videman T, Levalahti E, Battie MC. The effects of anthropometrics, lifting strength, and physical activities in disc degeneration. Spine. 2007;32:1406–1413
  25. Battie MC, Videman T. Lumbar disc degeneration: Epidemiology and genetics. J Bone Joint Surg Am. 2006;88(suppl 2):3–9
  26. Battie MC, Videman T, Parent E. Lumbar disc degeneration: Epidemiology and genetic influences. Spine. 2004;29:2679–2690
  27. Zhang Y, Sun Z, Liu J, et al. Advances in susceptibility genetics of intervertebral degenerative disc disease. Int J Biol Sci. 2008;4:283–290
  28. Watanabe H, Nakata K, Kimata K, et al. Dwarfism and age-associated spinal degeneration of heterozygote cmd mice defective in aggrecan. Proc Natl Acad Sci U S A. 1997;94:6943–6947
  29. Videman T, Battie MC, Gibbons LE, et al. Associations between back pain history and lumbar MRI findings. Spine. 2003;28:582–588
  30. Battie MC, Haynor DR, Fisher LD, et al. Similarities in degenerative findings on magnetic resonance images of the lumbar spines of identical twins. J Bone Joint Surg Am. 1995;77:1662–1670
  31. Battié MC, Videman T, Kaprio J, et al. The twin spine study: Contributions to a changing view of disc degeneration. Spine J. 2009;9:47–59
  32. Johnson WE, Roberts S. Human intervertebral disc cell morphology and cytoskeletal composition: A preliminary study of regional variations in health and disease. J Anat. 2003;203:605–612
  33. Hadjipavlou AG, Tzermiadianos MN, Bogduk N, et al. The pathophysiology of disc degeneration: A critical review. J Bone Joint Surg Br. 2008;90:1261–1270
  34. Haefeli M, Kalberer F, Saegesser D, et al. The course of macroscopic degeneration in the human lumbar intervertebral disc. Spine. 2006;31:1522–1531
  35. Olmarker K, Rydevik B, Nordborg C. Autologous nucleus pulposus induces neurophysiologic and histologic changes in porcine cauda equina nerve roots. Spine. 1993;18:1425–1432
  36. Zhao JG, Jia CQ, Zhang P. The possible process of neovascularization in degeneration intervertebral disc. Med Hypotheses. 2009;72:361–362
  37. Abe Y, Akeda K, An HS, et al. Proinflammatory cytokines stimulate the expression of nerve growth factor by human intervertebral disc cells. Spine. 2007;32:635–642
  38. Aoki Y, Ohtori S, Takahashi K, et al. Innervation of the lumbar intervertebral disc by nerve growth factor-dependent neurons related to inflammatory pain. Spine. 2004;29:1077–1081
  39. Weiler C, Nerlich AG, Bachmeier BE, et al. Expression and distribution of tumor necrosis factor alpha in human lumbar intervertebral discs: A study in surgical specimen and autopsy controls. discussion 54 Spine. 2005;30:44–53
  40. Brisby H. Pathology and possible mechanisms of nervous system response to disc degeneration. J Bone Joint Surg Am. 2006;88(suppl 2):68–71
  41. Modic MT. Modic type 1 and type 2 changes. J Neurosurg Spine. 2007;6:150–151
  42. Carragee E, Alamin T, Cheng I, et al. Are first-time episodes of serious LBP associated with new MRI findings?. Spine J. 2006;6:624–635
  43. Carragee EJ, Alamin TF, Miller JL, et al. Discographic, MRI and psychosocial determinants of low back pain disability and remission: A prospective study in subjects with benign persistent back pain. Spine J. 2005;5:24–35
  44. Kjaer P, Leboeuf-Yde C, Korsholm L, et al. Magnetic resonance imaging and low back pain in adults: A diagnostic imaging study of 40-year-old men and women. Spine. 2005;30:1173–1180
  45. Kleinstuck F, Dvorak J, Mannion AF. Are “structural abnormalities” on magnetic resonance imaging a contraindication to the successful conservative treatment of chronic nonspecific low back pain?. Spine. 2006;31:2250–2257
  46. Mitra D, Cassar-Pullicino VN, McCall IW. Longitudinal study of vertebral type-1 end-plate changes on MR of the lumbar spine. Eur Radiol. 2004;14:1574–1581
  47. Tertti M, Paajanen H, Laato M, et al. Disc degeneration in magnetic resonance imaging (A comparative biochemical, histologic, and radiologic study in cadaver spines). Spine. 1991;16:629–634
  48. Modic MT, Steinberg PM, Ross JS, et al. Degenerative disk disease: Assessment of changes in vertebral body marrow with MR imaging. Radiology. 1988;166:193–199

PII: S1084-208X(09)00013-5

doi: 10.1053/j.trap.2009.05.001

Techniques in Regional Anesthesia & Pain Management
Volume 13, Issue 2 , Pages 67-75 , April 2009