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Research ArticleSpecial Issue

Pathomechanism and Biomechanics of Degenerative Disc Disease: Features of Healthy and Degenerated Discs

Sertac Kirnaz, Charisse Capadona, Marianne Lintz, Byumsu Kim, Rachel Yerden, Jacob L. Goldberg, Branden Medary, Fabian Sommer, Lynn B. McGrath, Lawrence J. Bonassar and Roger Härtl
International Journal of Spine Surgery April 2021, 8052; DOI: https://doi.org/10.14444/8052
Sertac Kirnaz
1Department of Neurological Surgery, Weill Cornell Brain and Spine Center, Weill Cornell Medicine, New York Presbyterian Hospital, New York, New York
MD
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Charisse Capadona
1Department of Neurological Surgery, Weill Cornell Brain and Spine Center, Weill Cornell Medicine, New York Presbyterian Hospital, New York, New York
BS
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Marianne Lintz
2Meinig School of Biomedical Engineering, Cornell University, Ithaca, New York
MS
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Byumsu Kim
3Sibley School of Mechanical and Aerospace Engineering, Cornell University, Ithaca, New York
BS
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Rachel Yerden
2Meinig School of Biomedical Engineering, Cornell University, Ithaca, New York
BS
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Jacob L. Goldberg
1Department of Neurological Surgery, Weill Cornell Brain and Spine Center, Weill Cornell Medicine, New York Presbyterian Hospital, New York, New York
MD
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Branden Medary
1Department of Neurological Surgery, Weill Cornell Brain and Spine Center, Weill Cornell Medicine, New York Presbyterian Hospital, New York, New York
BA
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Fabian Sommer
1Department of Neurological Surgery, Weill Cornell Brain and Spine Center, Weill Cornell Medicine, New York Presbyterian Hospital, New York, New York
MD
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Lynn B. McGrath JR
1Department of Neurological Surgery, Weill Cornell Brain and Spine Center, Weill Cornell Medicine, New York Presbyterian Hospital, New York, New York
MD
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Lawrence J. Bonassar
2Meinig School of Biomedical Engineering, Cornell University, Ithaca, New York
3Sibley School of Mechanical and Aerospace Engineering, Cornell University, Ithaca, New York
PHD
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Roger Härtl
1Department of Neurological Surgery, Weill Cornell Brain and Spine Center, Weill Cornell Medicine, New York Presbyterian Hospital, New York, New York
MD
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ABSTRACT

The human intervertebral disc (IVD) is a complex organ composed of fibrous and cartilaginous connective tissues, and it serves as a boundary between 2 adjacent vertebrae. It provides a limited range of motion in the torso as well as stability during axial compression, rotation, and bending. Adult IVDs have poor innate healing potential due to low vascularity and cellularity. Degenerative disc disease (DDD) generally arises from the disruption of the homeostasis maintained by the structures of the IVD, and genetic and environmental factors can accelerate the progression of the disease. Impaired cell metabolism due to pH alteration and poor nutrition may lead to autophagy and disruption of the homeostasis within the IVD and thus plays a key role in DDD etiology. To develop regenerative therapies for degenerated discs, future studies must aim to restore both anatomical and biomechanical properties of the IVDs. The objective of this review is to give a detailed overview about anatomical, radiological, and biomechanical features of the IVDs as well as discuss the structural and functional changes that occur during the degeneration process.

  • degenerative disc disease
  • pathophysiology
  • biomechanics
  • intervertebral disc
  • back pain
  • low back pain
  • lumbar disc herniation

Footnotes

  • Disclosures and COI: Roger Härtl is a consultant for Ulrich, Brainlab, DePuy-Synthes, and he has royalties from Zimmer. The authors received no funding for this study.

  • This manuscript is generously published free of charge by ISASS, the International Society for the Advancement of Spine Surgery. Copyright © 2021 ISASS
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International Journal of Spine Surgery: 19 (S2)
International Journal of Spine Surgery
Vol. 19, Issue S2
1 Apr 2025
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Pathomechanism and Biomechanics of Degenerative Disc Disease: Features of Healthy and Degenerated Discs
Sertac Kirnaz, Charisse Capadona, Marianne Lintz, Byumsu Kim, Rachel Yerden, Jacob L. Goldberg, Branden Medary, Fabian Sommer, Lynn B. McGrath, Lawrence J. Bonassar, Roger Härtl
International Journal of Spine Surgery Apr 2021, 8052; DOI: 10.14444/8052

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Pathomechanism and Biomechanics of Degenerative Disc Disease: Features of Healthy and Degenerated Discs
Sertac Kirnaz, Charisse Capadona, Marianne Lintz, Byumsu Kim, Rachel Yerden, Jacob L. Goldberg, Branden Medary, Fabian Sommer, Lynn B. McGrath, Lawrence J. Bonassar, Roger Härtl
International Journal of Spine Surgery Apr 2021, 8052; DOI: 10.14444/8052
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Keywords

  • degenerative disc disease
  • pathophysiology
  • Biomechanics
  • Intervertebral disc
  • back pain
  • low back pain
  • lumbar disc herniation

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