Spinecare Topics

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Spine - Health and Disease
The Healing Spine

Spinal Tissue Remodeling and Repair

Stages of Healing the Spine

The body responds to injury with an inflammatory process that initiates a cascade of tissue repair and remodeling. The healing process has three identifiable stages or phases that occur over the time period of recovery, they are the inflammatory, proliferative, and remodeling stages.  Once tissue is injured, the process of healing begins immediately.

Phase 1: The Inflammatory Stage

The inflammatory stage is the first stage towards healing and remodeling of tissue.  During this stage cells are mobilized to the rescue. Specialized white blood cells migrate to the area of injury and begin to clean up the debris between the cells and around the blood vessels.  This is accompanied by the local release of blood clotting factors that help reduce and eventually halt bleeding from injured small blood vessels (capillaries).  During the inflammatory stage of healing, there is increased blood flow and migration of fluid into the injured area.  The initial inflammatory response generally lasts approximately 2-4 days after initial injury.  The intensity and duration of the inflammatory stage is related to the degree of tissue compromise.

During the course of inflammation, white blood cells and other cells, which perform cleanup activity migrates to the injured region.  This portion of the inflammatory reaction helps dispose of injured tissue byproducts that could continue to promote inflammation.  The cleanup process helps to set the stage for tissue repair.

The initial phase of healing is characterized by increased blood flow to the area secondary to blood vessel dilation.  The dilation of local blood vessels helps deliver the necessary white blood cells and other cellular elements to the region.  During this phase of healing, the specialized white blood cells cleanup most of the foreign debris helping set the stage for the next phase of healing, which is the fibroblastic-repair phase. 

Phase II: The Proliferative Phase (Fibroblastic Repair Phase)

The proliferative phase of healing begins during the inflammatory phase.  This begins by the second to fourth day after tissue compromise.  During the proliferative phase, specialized cells migrate to the area of compromise.  One of these cells is the fibroblast.  Fibroblasts have special properties that allow them to manufacture the building blocks for reparative tissue referred to as collagen.  Collagen is lined up and becomes oriented so that it can serve as an effective infrastructure for the reparative process to build upon. 

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