Intervertebral disc: anatomy-physiology-pathophysiology-treatment.
Pain Pract
; 8(1): 18-44, 2008.
Article
en En
| MEDLINE
| ID: mdl-18211591
ABSTRACT
This review article describes anatomy, physiology, pathophysiology and treatment of intervertebral disc. The intervertebral discs lie between the vertebral bodies, linking them together. The components of the disc are nucleus pulposus, annulus fibrosus and cartilagenous end-plates. The blood supply to the disc is only to the cartilagenous end-plates. The nerve supply is basically through the sinovertebral nerve. Biochemically, the important constituents of the disc are collagen fibers, elastin fibers and aggrecan. As the disc ages, degeneration occurs, osmotic pressure is lost in the nucleus, dehydration occurs, and the disc loses its height. During these changes, nociceptive nuclear material tracks and leaks through the outer rim of the annulus. This is the main source of discogenic pain. While this is occurring, the degenerative disc, having lost its height, effects the structures close by, such as ligamentum flavum, facet joints, and the shape of the neural foramina. This is the main cause of spinal stenosis and radicular pain due to the disc degeneration in the aged populations. Diagnosis is done by a strict protocol and treatment options are described in this review. The rationale for new therapies are to substitute the biochemical constituents, or augment nucleus pulposus or regenerate cartilaginous end-plate or finally artificial disc implantation..
Texto completo:
1
Bases de datos:
MEDLINE
Asunto principal:
Disco Intervertebral
Tipo de estudio:
Diagnostic_studies
/
Etiology_studies
/
Guideline
Límite:
Adolescent
/
Adult
/
Aged
/
Humans
/
Middle aged
Idioma:
En
Revista:
Pain Pract
Asunto de la revista:
NEUROLOGIA
/
PSICOFISIOLOGIA
Año:
2008
Tipo del documento:
Article
País de afiliación:
Estados Unidos