- Anatomy of The Spine
- Back Pain in Children
- Caring for your Spine
- Emerging Spinecare Trends
- Evaluation of Spinal Disorders
- Exercise and The Spine
- Intervention - Spinal Disorders
- Intervertebral Disc
- Non Surgical Options
- Nutrition and Spinecare
- Options for Spine Treatments
- Pregnancy and Back Pain
- Prevalence of Spine Disorders
- Sleep and the Spine
- Spinecare Introduction
- Spinehealth and Disease
- Surgical Interventions
- Treatment with Medications
- Understanding Back Pain
Spinecare Topics
Intervertebral Disc
Degenerative Disc Disease (DDD)
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Degenerative Disc Disease (DDD)
The intervertebral disc is a cartilaginous structure that resembles articular cartilage biochemically, but structurally it is quite different. The disc functions as a shock absorber and semi-flexible link between vertebrae. The intervertebral discs take considerable biomechanical stress from actions such as bending, twisting or jumping up and down. These stresses have a cumulative effect throughout life and consequently the disc undergoes degenerative changes earlier than any other connective tissue in the body. The normal aging process affects connective tissues of the disc as well, resulting in mild to moderate degeneration of the intervertebral discs in the aged population.
Intervertebral disc degeneration is strongly correlated with the development of low back pain. Degenerative disc disease (DDD) is extremely common, estimated to occur in 50% of individuals over 40 years of age and 80% of individuals over 70. DDD becomes increasing common as we get older. It occurs in part secondary to wear and tear similar to osteoarthrosis. It occurs most commonly in the lumbar spine, due to level of physical stress.
A healthy intervertebral disc has a great deal of water in the nucleus pulposus (the center portion of the disc). The center of the disc (nucleus pulposis) is composed of some large molecules called proteoglycans which attract water to a capacity approximately 250% of their weight. Until the third decade of life, the gel-like nucleus pulposus is composed of approximately 90% water. The water content gradually decreases over the subsequent 4-5 decades to approximately 65%. The water content gives the nucleus a spongy absorbing quality and allows it to dynamically adapt to loads placed on it. Excessive pressure on the disc can cause disruption of annular fibers (the outer ring of tough fibrous tissue) that holds the vertebrae together. The inner annulus is usually the first portion of the disc to become compromised. Small tears develop within annular fibers. These small tears can come together and become larger regions of compromise. Annular tears heal by scar tissue, which is not as strong as normal tissue. The annulus becomes weakened over time as circumferential tears enlarge and scar tissue forms.
The adult disc does not have a blood supply and is therefore dependent on blood vessels along their margins and within adjacent bone to supply nutrients and remove metabolic products. Damage of the endplate which comprises the surfaces of the vertebral bodies can lead to disc degeneration by limiting chemical (metabolite) transport from the vertebral body into the center of the disc (nucleus), or by causing an inflammatory or autoimmune type reaction within the disc or the vertebral body.
The delivery of adequate nutrition to the inner fibers of the disc (annulus fibrosis) and to the center portion of the disc (nucleus pulposus) depends on the diffusion of water and small molecular substances across the vertebral endplates. The outer third of the disc (annular fibers) receives nutrients via diffusion via a blood supply around the disc.
Intervertebral disc degeneration is strongly correlated with the development of low back pain. Degenerative disc disease (DDD) is extremely common, estimated to occur in 50% of individuals over 40 years of age and 80% of individuals over 70. DDD becomes increasing common as we get older. It occurs in part secondary to wear and tear similar to osteoarthrosis. It occurs most commonly in the lumbar spine, due to level of physical stress.
A healthy intervertebral disc has a great deal of water in the nucleus pulposus (the center portion of the disc). The center of the disc (nucleus pulposis) is composed of some large molecules called proteoglycans which attract water to a capacity approximately 250% of their weight. Until the third decade of life, the gel-like nucleus pulposus is composed of approximately 90% water. The water content gradually decreases over the subsequent 4-5 decades to approximately 65%. The water content gives the nucleus a spongy absorbing quality and allows it to dynamically adapt to loads placed on it. Excessive pressure on the disc can cause disruption of annular fibers (the outer ring of tough fibrous tissue) that holds the vertebrae together. The inner annulus is usually the first portion of the disc to become compromised. Small tears develop within annular fibers. These small tears can come together and become larger regions of compromise. Annular tears heal by scar tissue, which is not as strong as normal tissue. The annulus becomes weakened over time as circumferential tears enlarge and scar tissue forms.
The adult disc does not have a blood supply and is therefore dependent on blood vessels along their margins and within adjacent bone to supply nutrients and remove metabolic products. Damage of the endplate which comprises the surfaces of the vertebral bodies can lead to disc degeneration by limiting chemical (metabolite) transport from the vertebral body into the center of the disc (nucleus), or by causing an inflammatory or autoimmune type reaction within the disc or the vertebral body.
The delivery of adequate nutrition to the inner fibers of the disc (annulus fibrosis) and to the center portion of the disc (nucleus pulposus) depends on the diffusion of water and small molecular substances across the vertebral endplates. The outer third of the disc (annular fibers) receives nutrients via diffusion via a blood supply around the disc.
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