Song Chao, Cai Weiye, Liu Fei, Cheng Kang, Guo Daru, Liu Zongchao
Department of Orthopedics and Traumatology (Trauma and Bonesetting) The Affiliated Hospital of Traditional Chinese Medicine of Southwest Medical University Luzhou China.
JOR Spine. 2022 Dec 8;5(4):e1233. doi: 10.1002/jsp2.1233. eCollection 2022 Dec.
Intervertebral disc degeneration (IVDD) is the pathological basis of disc herniation, spinal stenosis, and other related diseases, and the lower back pain it produces lays a heavy financial burden on individuals and society. Thus, it is essential to comprehend IVDD's pathophysiology. Numerous factors, such as inflammatory factors, oxidative stress, apoptosis, matrix metalloproteinases, are linked to IVDD pathogenesis. Despite the fact that many researches has provided explanations for the pathophysiology of IVDD, these studies are typically singular, restricted, and isolated, expound only on one or two components, and do not systematically analyze and summarize the numerous influencing elements. In addition, we discovered that the incidence of many chronic diseases in the field of orthopedics may be thoroughly and systematically defined in terms of immunological systems. In order to provide a theoretical foundation for an in-depth understanding of the pathological process of IVDD and the formulation of more effective prevention and treatment measures, this review provides a comprehensive and systematic account of the pathogenesis of IVDD from the physical to the molecular barriers of the intervertebral disc, from the nucleus pulposus tissue to the cellular to the immune-molecular level.
椎间盘退变(IVDD)是椎间盘突出、椎管狭窄及其他相关疾病的病理基础,其所引发的下腰痛给个人和社会带来了沉重的经济负担。因此,了解IVDD的病理生理学至关重要。许多因素,如炎症因子、氧化应激、细胞凋亡、基质金属蛋白酶等,都与IVDD的发病机制相关。尽管许多研究对IVDD的病理生理学进行了解释,但这些研究通常是单一、有限且孤立的,仅阐述一两个方面,并未对众多影响因素进行系统分析和总结。此外,我们发现骨科领域的许多慢性疾病的发病情况可以从免疫系统的角度进行全面系统的界定。为了为深入理解IVDD的病理过程以及制定更有效的防治措施提供理论基础,本综述从椎间盘的物理屏障到分子屏障,从髓核组织到细胞水平再到免疫分子水平,对IVDD的发病机制进行了全面系统的阐述。