Mechanical Aspects of Intervertebral Disc Injury and Implications on Biomechanics.

作者：G. Desmoulin, Vikram Pradhan, T. Milner · 发表于：Spine · 年份：2020 · DOI：10.1097/brs.0000000000003291 · 被引用次数：147 · 研究领域：Medicine

STUDY DESIGN This article comprises a review of the literature. OBJECTIVE The purpose of this study was to elucidate the different types of structural failures exhibited in IVDs, summarize their potential causes with respect to mechanical loading conditions and the consequences on cell homeostasis and biomechanics. SUMMARY OF BACKGROUND DATA Many studies have been performed to gain insight into how discogenic back pain progresses in humans both in-vitro and in-vivo as well as in animal disc models. However, there is a major need to summarize the common factors which initiate the structural failures observed in intervertebral discs (IVDs) and the typical biomechanical changes. This work could help in developing mechanisms aiming to restore the biochemical and biomechanical balance of IVDs. METHODS The different types of structural failures encountered in IVDs were reviewed from published literature. The types of mechanical loading causing these injuries and their physiological and biomechanical consequences were then summarized and linked to ongoing research in this area. RESULTS The most prominent structural failures associated with IVDs are annulus tears, disc prolapse, endplate damage, disc narrowing, radial bulging and osteophyte formation in the vertebrae. IVDs were found to be vulnerable to compression, flexion, axial rotation as well as complex loading mechanisms through both single impact, cyclical and continuous loading. However, chronic loadings had a more da...