Pathophysiology of lumbar disc degeneration: a review of the literature

MICHAEL D. MARTIN, M.D., CHRISTOPHER M. BOXELL, M.D., F.A.C.S., AND DAVID G. MALONE, M.D.

Neurosurg. Focus / Volume 13 / August, 2002

Department of Neurological Surgery, University of Oklahoma, Oklahoma City; and Oklahoma Spine and Brain Institute, Tulsa, Oklahoma Lumbar disc degeneration occurs because of a variety of factors and results in a multitude of conditions. Alterations in the vertebral endplate cause loss of disc nutrition and disc degeneration. Aging, apoptosis, abnormalities in colla-gen, vascular ingrowth, loads placed on the disc, and abnormal proteoglycan all contribute to disc degeneration. Some forms of disc degeneration lead to loss of height of the motion segment with concomitant changes in biomechanics of the segment. Disc herniation with radiculopathy and chronic discogenic pain are the result of this degenerative process.