Corporal Michael J. Crescenz VA Medical Centre, Research, Building 21, Rm A214, 3900 Woodland Ave, Philadelphia, PA 19104,
Eur Cell Mater. 2021 Mar 24;41:370-380. doi: 10.22203/eCM.v041a24.
Back and neck pain have become primary reasons for disability and healthcare spending globally. While the causes of back pain are multifactorial, intervertebral disc degeneration is frequently cited as a primary source of pain. The annulus fibrosus (AF) and nucleus pulposus (NP) subcomponents of the disc are common targets for regenerative therapeutics. However, disc degeneration is also associated with degenerative changes to adjacent spinal tissues, and successful regenerative therapies will likely need to consider and address the pathology of adjacent spinal structures beyond solely the disc subcomponents. This review summarises the current state of knowledge in the field regarding associations between back pain, disc degeneration, and degeneration of the cartilaginous and bony endplates, the AF-vertebral body interface, the facet joints and spinal muscles, in addition to a discussion of regenerative strategies for treating pain and degeneration from a whole motion segment perspective.
背痛和颈痛已成为全球残疾和医疗保健支出的主要原因。虽然背痛的原因是多因素的，但椎间盘退行性变常常被认为是疼痛的主要来源。椎间盘的纤维环（AF）和髓核（NP）亚成分是再生治疗的常见靶点。然而，椎间盘退行性变也与相邻脊柱组织的退行性变化有关，成功的再生治疗可能需要考虑和解决除椎间盘亚成分之外的相邻脊柱结构的病理学。这篇综述总结了目前在该领域的知识状态，包括背痛、椎间盘退行性变以及软骨和骨终板、纤维环-椎体界面、小关节和脊柱肌肉的退行性变之间的关联，此外还讨论了从整个运动节段的角度治疗疼痛和退行性变的再生策略。
