scholarly journals Innervation of the human intervertebral disc: a scoping review

Pain Medicine ◽  
2021 ◽  
Author(s):  
Adam M R Groh ◽  
Dale E Fournier ◽  
Michele C Battié ◽  
Cheryle A Séguin
Keyword(s):  
Back Pain ◽  
Intervertebral Disc ◽  
Nucleus Pulposus ◽  
Scoping Review ◽  
Annulus Fibrosus ◽  
Sensory Nerves ◽  
Disease States ◽  
Perivascular Nerves ◽  
And Function ◽  
Underlying Pathology

Abstract Objective: Back pain is an elusive symptom complicated by a variety of possible causes, precipitating and maintaining factors, and consequences. Notably, the underlying pathology remains unknown in a significant number of cases. Changes to the intervertebral disc (IVD) have been associated with back pain, leading many to postulate that the IVD may be a direct source of pain, typically referred to as discogenic back pain. Yet, despite decades of research into the neuroanatomy of the IVD, there is a lack of consensus in the literature as to the distribution and function of neural elements within the tissue. The current scoping review provides a comprehensive systematic overview of studies that document the topography, morphology, and immunoreactivity of neural elements within the IVD in humans. <uMel>thod: Articles were retrieved from six separate databases in a three-step systematic search, and independently evaluated by two reviewers. <Resul>ults: Three categories of neural elements were described within the IVD: perivascular nerves, sensory nerves independent of blood vessels, and mechanoreceptors. Nerves were consistently localized within the outer layers of the annulus fibrosus. Neural ingrowth into the inner annulus fibrosus and nucleus pulposus was found to occur only in degenerative states and disease states. Conclusion: While the pattern of innervation within the IVD is clear, the specific topographic arrangement and function of neural elements in the context of back pain remains unclear.

scholarly journals Disordered Mechanical Stress and Tissue Engineering Therapies in Intervertebral Disc Degeneration

Polymers ◽  
2019 ◽  
Vol 11 (7) ◽  
pp. 1151 ◽  
Author(s):  
Runze Zhao ◽  
Wanqian Liu ◽  
Tingting Xia ◽  
Li Yang
Keyword(s):  
Tissue Engineering ◽  
Back Pain ◽  
Intervertebral Disc ◽  
Mechanical Stress ◽  
Nucleus Pulposus ◽  
Disc Degeneration ◽  
Annulus Fibrosus ◽  
Intervertebral Disc Degeneration ◽  
Intervertebral Discs ◽  
Body Motion

Low back pain (LBP), commonly induced by intervertebral disc degeneration, is a lumbar disease with worldwide prevalence. However, the mechanism of degeneration remains unclear. The intervertebral disc is a nonvascular organ consisting of three components: Nucleus pulposus, annulus fibrosus, and endplate cartilages. The disc is structured to support our body motion and endure persistent external mechanical pressure. Thus, there is a close connection between force and intervertebral discs in LBP. It is well established that with aging, disordered mechanical stress profoundly influences the fate of nucleus pulposus and the alignment of collagen fibers in the annulus fibrosus. These support a new understanding that disordered mechanical stress plays an important role in the degeneration of the intervertebral discs. Tissue-engineered regenerative and reparative therapies are being developed for relieving disc degeneration and symptoms of lower back pain. In this paper, we will review the current literature available on the role of disordered mechanical stress in intervertebral disc degeneration, and evaluate the existing tissue engineering treatment strategies of the current therapies.

The Influence of Axial Compression on the Cellular and Mechanical Function of Spinal Tissues; Emphasis on The Nucleus Pulposus and Annulus Fibrosus

2021 ◽  
Author(s):  
John McMorran ◽  
Diane Gregory
Keyword(s):  
Intervertebral Disc ◽  
Nucleus Pulposus ◽  
Axial Compression ◽  
Disc Degeneration ◽  
Annulus Fibrosus ◽  
Intervertebral Disc Degeneration ◽  
Chronic Back Pain ◽  
Physiological State ◽  
Movement Pattern ◽  
Mechanical Function

Abstract In light of the correlation between chronic back pain and intervertebral disc degeneration, this literature review seeks to illustrate the importance of the hydraulic response across the nucleus pulposus- annulus fibrosus interface, by synthesizing current information regarding injurious biomechanics of the spine, stemming from axial compression. Damage to vertebrae, endplates, the nucleus pulposus, and the annulus fibrosus, can all arise from axial compression, depending on the segment's posture, the manner in which it is loaded, and the physiological state of tissue. Therefore, this movement pattern was selected to illustrate the importance of the bracing effect of a pressurized nucleus pulposus on the annulus fibrosus, and how injuries interrupting support to the annulus fibrosus may contribute to intervertebral disc degeneration.

Experimentally Validated Computational Simulation of Lumbar Spine Intervertebral Disc Puncture

2011 ◽  
Author(s):  
Kristen E. Lipscomb ◽  
Nesrin Sarigul-Klijn
Keyword(s):  
Back Pain ◽  
Lumbar Spine ◽  
Intervertebral Disc ◽  
Nucleus Pulposus ◽  
Chronic Back Pain ◽  
Medical Condition ◽  
Computational Simulation ◽  
Element Model ◽  
Before And After ◽  
Spine Model

Back pain is a debilitating medical condition, often with an unclear source. Over time, back pain can affect the work and lifestyle of an individual by reducing job productivity and time spent on enjoyable activities. Discography of the intervertebral disc (IVD) is often used to diagnose pathology of the disc and determine if it may be a source for chronic back pain. It has recently been suggested that discography may lead to IVD degeneration, and has been a cause of controversy among spine care physicians. Using the results from a cadaveric experimental model, a finite element model was first validated. Then, a study was conducted to better understand the changes caused by discography on human spine mechanics. An anatomically accurate L3-L5 lumbar spine model was developed using computed tomography scans. Discography was simulated in the model as an area in the disc affected by needle puncture. The material properties in the nucleus pulposus were adjusted to match experimental data both before and after puncture. The results show that puncture of the IVD leads to increased deformation as well as increased stresses in the disc. Pressure in the nucleus pulposus found to decrease after puncture, and was calculated in the course of this study. Puncturing the IVD changes disc mechanics and may lead to progressive spine issues in the future such as disc degeneration. While discography has been the gold standard to determine if the disc was a source of back pain in patients for many years, the potential long-term degenerative effects of the procedure are only now coming into light, and must be closely examined.

scholarly journals Early differentation of lamellar structure of the intervertebral disc in staged human embryos

2015 ◽  
Vol 84 (3) ◽  
pp. 157-166
Author(s):  
Witold Woźniak ◽  
Małgorzata Grzymisławska ◽  
Joanna Łupicka ◽  
Małgorzata Bruska ◽  
Adam Piotrowski ◽  
...  
Keyword(s):  
Intervertebral Disc ◽  
Nucleus Pulposus ◽  
Annulus Fibrosus ◽  
Developmental Stages ◽  
Intervertebral Discs ◽  
Human Embryos ◽  
Lateral Zone ◽  
Vast Literature ◽  
Dense Zone

Introduction. In the vast literature concerning the development of the intervertebral discs controversies exist as to the period of differentiation and structure of the nucleus pulposus and annulus fibrosus. These controversies result from different determination of age of the investigated embryos. Aim. Using embryos from departmental collection age of which was established according to international Carnegie staging and expressed in postfertilizational days, the differentiation of the intervertebral discs was traced. Material and methods. Study was performed on 34 embryos at developmental stages 13–23 (32–56 days). Embryos were serially sectioned in sagittal, frontal and horizontal planes. Sections were stained with various histological methods and impregnated with silver.Results. Division of sclerotomes into loose cranial and dense caudal zones (sclerotomites) was observed in embryos aged 32 days (stage 13). The intervertebral disc developed from the dense zone of sclerotome and was well recognized in embryos aged 33 days (stage 14). At the end of fifth week (embryos at stage 15, 36 days) the annulus fibrosus and the nucleus pulposus were seen. The annulus fibrosus differentiated into lateral and medial zones. Within the lateral zone cells were arranged into circular rows. These rows were considered as the first stage of laminar structure. In further developmental stages the laminae occupied both zones of the annulus fibrosus.Conclusions. The intervertebral discs develop from the dense zone of the sclerotome which is evident in embryos at stage 13 (32 days). Discs differentiate in embryos aged 33 days, when the nucleus pulposus and annulus fibrosus are recognized. In embryos aged 36 days in the annulus fibrosus circular rows forming laminar arrangement are seen.

Isolation of Nucleus Pulposus and Annulus Fibrosus Cells from the Intervertebral Disc

2020 ◽  
pp. 41-52
Author(s):  
Guus G. H. van den Akker ◽  
Andy Cremers ◽  
Donatus A. M. Surtel ◽  
Willem Voncken ◽  
Tim J. M. Welting
Keyword(s):  
Intervertebral Disc ◽  
Nucleus Pulposus ◽  
Annulus Fibrosus

scholarly journals Discography interpretation and techniques in the lumbar spine

2002 ◽  
Vol 13 (2) ◽  
pp. 1-8 ◽  
Author(s):  
Frank J. Tomecek ◽  
C. Scott Anthony ◽  
Chris Boxell ◽  
Jennifer Warren
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Lumbar Spine ◽  
Intervertebral Disc ◽  
Nucleus Pulposus ◽  
Diagnostic Test ◽  
Diagnostic Tool ◽  
Radiographic Evaluation ◽  
Low Back

The authors provide an indepth analysis of discography, a provocative diagnostic tool to determine the origin of low-back pain. Injecting the intervertebral disc with radiopaque dye provides physicians with several useful pieces of information. First, the modality provides radiographic evaluation of the integrity of the nucleus pulposus and anular rings to determine tears or other lesions that could be creating low-back pain. Second, and very important, is its measure of disc nociception. A normal disc should not cause pain when injected; however, a disc that is physiologically compromised can mimic the pain previously experienced by a patient. The authors review the indications, technique, and interpretation of discography to allow a better understanding of when to use this diagnostic test and what to do with the results.

Effects of Swelling Conditions on the Compressive Properties of Nucleus Pulposus From Bovine Intervertebral Discs

2004 ◽  
Author(s):  
David T. Korda ◽  
Delphine Perie ◽  
James C. Iatridis
Keyword(s):  
Intervertebral Disc ◽  
Water Content ◽  
Nucleus Pulposus ◽  
Annulus Fibrosus ◽  
Compressive Loading ◽  
Collagen Matrix ◽  
High Water ◽  
Intervertebral Discs ◽  
High Water Content ◽  
Outer Annulus Fibrosus

The intervertebral disc provides flexibility and load support for the spine. It consists of two main regions; the outer annulus fibrosus which is a highly organized collagen matrix and the inner nucleus pulposus which (in a healthy disc) is a proteoglycan rich gelatinous material. The predominant mode of loading on the intervertebral disc is axial compression, which generates hydrostatic pressures within the disc. The high water content of the nucleus plays a major role in supporting these loads. With age and degeneration, the water content of the nucleus changes, and is believed to significantly impact its ability to bear load. The purpose of this study therefore, was to define the effects of swelling conditions (which affect disc hydration) on the material properties of the disc under compressive loading.

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