Role of oxidative stress in intervertebral disc degeneration: mechanisms, pathogenesis, and therapeutic strategies.

Intervertebral disc degeneration (IDD) is a prevalent and debilitating spinal condition, characterised by the progressive degradation of disc structure and function, often accompanied by pain. Despite our increasing understanding of IDD, the precise mechanisms underlying its development and potential therapeutic targets remain incompletely understood. Recent research has highlighted that oxidative stress, along with immune abnormalities, mechanical loading imbalances, and metabolic disruptions, play a pivotal role in IDD initiation and progression. Oxidative stress in IDD results from an overproduction of reactive oxygen species (ROS) and a compromised ability to eliminate them, disrupting the redox homeostasis within the intervertebral disc. This disturbance in redox balance leads to extracellular matrix degradation (ECM), induces cellular apoptosis, and worsens the damage to disc tissues. This review provides a comprehensive overview of the pathophysiological processes of IDD, with a particular focus on the role of oxidative stress. Additionally, we explore current advancements in therapeutic strategies targeting oxidative stress, including antioxidant drugs, biomaterials, and stem cell-based approaches, offering promising avenues for the management and treatment of IDD.