Department of Orthopaedics, 2nd Affiliated Hospital, School of Medicine, Zhejiang University, #88 Jiefang Road, Hangzhou 310009, China.
Med Hypotheses. 2010 Aug;75(2):169-71. doi: 10.1016/j.mehy.2010.02.012.
The intravertebral vacuum phenomenon (VP) is usually associated with degenerative disc disease, which could be related to the low back pain. Various theories related to the pathogenesis of VP have been proposed, but these theories have not been critically examined and remain hypothetical. In this article, we review the possible role of endplate degeneration in the pathogenesis of VP, and discuss several pathways possibly linked to them. Due to the endplate calcification and activated cytokines, the transport pathway of the nutrition for the intervertebral disc was blocked, resulting in the metabolic unbalance and decrease of the synthesis of matrix structural proteins. It could promote the matrix decomposition, causing the decrease of the quantity of matrix and the changes of stress distribution in intervertebral disc. As a result, the structure of intervertebral discs became increasingly unstable. While compression happened, the intravertebral cleft could occur and be gradually filled with gas, which may cause low back pain and aggravate the intervertebral discs degeneration. As outlined above, we hypothesize that endplate degeneration might be the origination of the vacuum phenomenon.
椎体内真空现象（VP）通常与退行性椎间盘疾病相关，而后者可能与下腰痛有关。已经提出了多种与 VP 发病机制相关的理论，但这些理论尚未经过严格检查，仍属于假设。在本文中，我们回顾了终板退变在 VP 发病机制中的可能作用，并讨论了与之相关的几种途径。由于终板钙化和激活的细胞因子，椎间盘营养的运输途径被阻断，导致代谢失衡和基质结构蛋白合成减少。这可能会促进基质分解，导致基质数量减少以及椎间盘内应力分布的改变。结果，椎间盘的结构变得越来越不稳定。当发生压缩时，椎体内裂隙可能发生并逐渐充满气体，这可能导致下腰痛并加重椎间盘退变。如上所述，我们假设终板退变可能是真空现象的起源。
