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Immunobiological aspects of acute discogenic pain of low back pain

Authors
Publisher
Croatian Society of Natural Sciences
Publication Date
Keywords
  • Cytokine
  • Disc
  • Back Pain
  • Immunology
Disciplines
  • Biology
  • Medicine

Abstract

uhoda.vp Immunobiological aspects of acute discogenic pain of low back pain INTRODUCTION Low back pain is the most common health problem for individualsbetween the ages of 20 and 50 years. In most cases, the origin of low back pain remains unsolved. Many of established anatomic causes of low back pain are believed to arise from damage of the intervertebral disc (IVD) indirectly through degeneration. Although causal relation- ship between disc degeneration and low back pain is not yet definitive, in some cases, pathogenetic mechanisms have been elucidated. For ex- ample, Moran and King (1) showed that spinal instability was one of the most common causes of low back pain, and other studies have shown that the degenerative process in discs is characterized by insta- bility, especially in traumatic pathology. Although disc degeneration is of great clinical importance, much re- mains unknown about its etiology and pathogenesis. Conditions that cause degradation of nuclear and annular material properties and hence the load bearing properties of the disc may lead to damage of other spinal structures, resulting in disc collapse, herniation or spon- dylosis. Among the many suspected conditions such as mechanical fac- tors, genetics, and systemic factors, insufficient nutrition of the disc has been suspected as the underlying factor in disc degeneration (2, 8). Nutrition and metabolism of intervertebral disc The adult human disc is the largest avascular structure in the body. In adult discs, some cells may be as much as 6 to 8 mm from the nearest blood supply, which resides in the osseous endplate of the adjacent ver- tebral bodies. The vertebral endplate is covered by a thin layer of hyaline cartilage, the cartilaginous endplate, the deep calcified layer, and the underlying subchondral bone. The mineralized portion of endplate is penetrated by marrow contact channels (MCC), through which capillary buds emerge. These capillary buds connect the trabe- cular spaces to the cartilaginous endp

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