Percutaneous Laser Disc Decompression pp 29-57 | Cite as
Anatomy and Pathophysiology of Intervertebral Discs
- 160 Downloads
Conclusions
The intervertebral disc is considered to be the primary focus of pathology for the majority of patients with low back pain. The structure of the disc has been well described in the literature. The metabolism and nutrition of the intervertebral disc remain unclear. Physicochemical changes in disc tissue with mechanical loading and aging have been identified to a limited extent. Innervation of the normal and abnormal disc and neurochemical changes within the disc in pathologic conditions are the focus of current investigations. The mechanism of pain generation and the pathway of pain conduction in low back pain and sciatica, however, are not known.
Keywords
Nerve Root Intervertebral Disc Nucleus Pulposus Disc Herniation Disc DegenerationPreview
Unable to display preview. Download preview PDF.
References
- 1.Coventry MB, Ghormley RK, Kernohan JW. The intervertebral disc: its microscopic anatomy and pathology, II: changes in the intervertebral disc concomitant with aging. J Bone Joint Surg Am 1945; 27:233–247.Google Scholar
- 2.Cotten A, Sakka M, Drizenko A, Clarisse J, Francke JP. Antenatal differentiation of the human intervertebral disc. Surg Radiol Anat 1994;16(1):53–56.PubMedCrossRefGoogle Scholar
- 3.McNally DS, Adams MA. Internal intervertebral disc mechanics as revealed by stress profilometry. Spine 1992;17(1):66–73.PubMedGoogle Scholar
- 4.Kraemer, J. Presidential address: natural course and prognosis of intervertebral disc diseases. Spine 1995;20(6):635–639.PubMedGoogle Scholar
- 5.Nachemson A. Newest knowledge of low back pain. A critical look. Clin Orthop 1992;271:8–20.Google Scholar
- 6.Huang R, Zhi Q, Wilting J, Christ B. The fate of somitocoele cells in avian embryos. Anat Embryol Berl 1994;190(3):243–250.PubMedGoogle Scholar
- 7.Thompson JP, Oegema TR Jr, Bradford DS. Stimulation of mature canine intervertebral disc by growth factors. Spine 1991;16(3):253–260.PubMedGoogle Scholar
- 8.Marchand F, Ahmed AM. Investigation of the laminate structure of lumbar disc anulus fibrosus. Spine 1990;15(5):402–410.PubMedGoogle Scholar
- 9.Tsuji H, Hirano N, Ohshima H, Ishihara H, Terahata N, Motoe T. Structural variation of the anterior and posterior anulus fibrosus in the development of human lumbar intervertebral disc. A risk factor for intervertebral disc rupture. Spine 1993;18(2):204–210.PubMedGoogle Scholar
- 10.Beattie PF, Brooks WM, Rothstein JM, Sibbitt WL Jr, Robergs RA, MacLean T, Hart BL. Effect of lordosis on the position of the nucleus pulposus in supine subjects. A study using magnetic resonance imaging. Spine 1994;19(18):2096–2102.PubMedGoogle Scholar
- 11.MacMillan J, Schaffer JL, Kambin P. Routes and incidence of communication of lumbar discs with surrounding neural structures. Spine 1991;16(2):167–171.PubMedGoogle Scholar
- 12.Fujita K, Nakagawa T, Hirabayashi K, Nagai Y. Neutral proteinases in human intervertebral disc. Role in degeneration and probable origin. Spine 1993;18(13):1766–1773.PubMedGoogle Scholar
- 13.Roberts S, Menage J, Duance V, Wotton S, Ayad S. 1991 Volvo Award in basic sciences. Collagen types around the cells of the intervertebral disc and cartilage end plate: an immunolocalization study. Spine 1991;16(9):1030–1038.PubMedGoogle Scholar
- 14.Rydevik B, Brown MD, Lundborg G. Pathoanatomy and pathophysiology of nerve root compression. Spine 1984;9:7–15.PubMedGoogle Scholar
- 15.Rauschning W. Normal and pathologic anatomy of the lumbar root canals. Spine 1987;12(10):1008–1019.PubMedGoogle Scholar
- 16.Smith SA, Massie JB, Chesnut R, Garfin SR. Straight leg raising. Anatomical effects on the spinal nerve root without and with fusion. Spine 1993;18(8):992–999.PubMedGoogle Scholar
- 17.Sato K, Kikuchi S. An anatomic study of foraminal nerve root lesions in the lumbar spine. Spine 1993;18(15):2246–2251.PubMedGoogle Scholar
- 18.Okuwaki T, Kunogi J, Hasue M. Conjoined nerve roots associated with lumbosacral spine anomalies. A case report. Spine 1991;16(11):1347–1349.PubMedGoogle Scholar
- 19.Gomez JG, Dickey JW, Bachow TB. Conjoined lumbosacral nerve roots. Acta Neurochir Wien 1993;120(3–4):155–158.PubMedCrossRefGoogle Scholar
- 20.Piatt JH Jr. The frequency of intradural conjoined lumbosacral dorsal nerve roots found during selective dorsal rhizotomy [letter; comment]. Neurosurgery 1994;34(2):380.PubMedGoogle Scholar
- 21.Phillips LH 2d, Park TS. The frequency of intradural conjoined lumbosacral dorsal nerve roots found during selective dorsal rhizotomy. Neurosurgery 1993;33(1):88–90; discussion 90—91.PubMedGoogle Scholar
- 22.Kubo Y, Waga S, Kojima T, Matsubara T, Kuga Y, Nakagawa Y. Microsurgical anatomy of the lower cervical spine and cord. Neurosurgery 1994;34(5):895–890; discussion 901–902.PubMedGoogle Scholar
- 23.Ohshima H, Hirano N, Osada R, Matsui H, Tsuji H. Morphologic variation of lumbar posterior longitudinal ligament and the modality of disc herniation. Spine 1993;18(16):2408–2011.PubMedGoogle Scholar
- 24.Stephens MM, Evans JH, O’Brien JP. Lumbar intervertebral foramens. An in vitro study of their shape in relation to intervertebral disc pathology. Spine 1991;16(5):525–529.PubMedGoogle Scholar
- 25.Zimmerman MC, Vuono-Hawkins M, Parsons JR, Carter FM, Gutteling E, Lee CK, Langrana NA. The mechanical properties of the canine lumbar disc and motion segment. Spine 1992;17(2):213–220.PubMedGoogle Scholar
- 26.Adams MA, Green TP, Dolan P. The strength in anterior bending of lumbar intervertebral discs. Spine 1994;19(19):2197–2203.PubMedGoogle Scholar
- 27.Taylor TK, Akeson WH. Intervertebral disc prolapse: a review of morphologic and biochemical knowledge concerning the nature of prolapse. Clin Orthop 1971;76:54–79.PubMedGoogle Scholar
- 28.Parke WW, Watanabe R. The intrinsic vasculature of the lumbosacral spinal nerve roots. Spine 1985;10:508–515.PubMedGoogle Scholar
- 29.Stairmand JW, Holm S, Urban JP. Factors influencing oxygen concentration gradients in the intervertebral disc. A theoretical analysis. Spine 1991;16(4):444–449.PubMedGoogle Scholar
- 30.Yasuma T, Arai K, Yamauchi Y. The histology of lumbar intervertebral disc herniation. The significance of small blood vessels in the extruded tissue. Spine 1993;18(13):1761–1765.PubMedGoogle Scholar
- 31.Yamashita T, Minaki Y, Oota I, Yokogushi K, Ishii S. Mechanosensitive afferent units in the lumbar intervertebral disc and adjacent muscle. Spine 1993;18(15):2252–2256.PubMedGoogle Scholar
- 32.McCarthy PW, Carruthers B, Martin D, Petts P. Immunohistochemical demonstration of sensory nerve fibers and endings in lumbar intervertebral discs of the rat. Spine 1991;16(6):636–653.Google Scholar
- 33.Yoshizawa H, O’Brien JH, Smith WT, Trumper M. The neuropathology of intervertebral discs removed for low back pain. J Pathol 1980;132:95.PubMedCrossRefGoogle Scholar
- 34.Ashton IK, Roberts S, Jaffray DC, Polak JM, Eisenstein SM. Neuropeptides in the human intervertebral disc. J Orthop Res 1994;12(2): 186–192.PubMedCrossRefGoogle Scholar
- 35.Coppes MH, Marani E, Thomeer RT, Oudega M. Innervation of annulus fibrosis in low back pain. Lancet 1990;336:189–190.PubMedCrossRefGoogle Scholar
- 36.Mendel T, Wink CS, Zimny ML. Neural elements in human cervical intervertebral discs. Spine 1992;17(2):132–135.PubMedGoogle Scholar
- 37.Groen GJ, Baljet B, Drukker J. Nerves and nerve plexuses of the human vertebral column. Am J Anat 1990;188:282–296.PubMedCrossRefGoogle Scholar
- 38.Scott JE, Bosworth TR, Cribb AM, Taylor JR. The chemical morphology of age-related changes in human intervertebral disc glycosaminoglycans from cervical, thoracic and lumbar nucleus pulposus and annulus fibrosus. J Anat 1994;184(pt 1):73–82.PubMedGoogle Scholar
- 39.Brickley-Parsons D, Glimcher MJ. Is the chemistry of collagen in intervertebral discs an expression of Wolff’s law? A study of the human lumbar spine. Spine 1984;9:148–163.PubMedGoogle Scholar
- 40.Neufeld JH. Induced narrowing and back adaptation of lumbar intervertebral discs in biomechanically stressed rats. Spine 1992;17(7): 811–816.PubMedGoogle Scholar
- 41.Botsford DJ, Esses SI, Ogilvie-Harris DJ. In vivo diurnal variation in intervertebral disc volume and morphology. Spine 1994;19(8): 935–940.PubMedGoogle Scholar
- 42.Paajanen H, Lehto I, Alanen A, Erkintalo M, Komu M. Diurnal fluid changes of lumbar discs measured indirectly by magnetic resonance imaging. J Orthop Res 1994;12(4):509–514.PubMedCrossRefGoogle Scholar
- 43.Krag MH, Cohen MC, Haugh LD, Pope MH. Body height change during upright and recumbent posture. Spine 1990;15(3):202–207.PubMedGoogle Scholar
- 44.LeBlanc AD, Evans HJ, Schneider VS, Wendt RE 3rd, Hedrick TD. Changes in intervertebral disc cross-sectional area with bed rest and space flight. Spine 1994;19(7):812–817.PubMedGoogle Scholar
- 45.Glover MG, Hargens AR, Mahmood MM, Gott S, Brown MD, Garfin SR. A new technique for the in vitro measurement of nucleus pulposus swelling pressure. J Orthop Res 1991;9(1):61–67.PubMedCrossRefGoogle Scholar
- 46.Fowler NE, Lees A, Reilly T. Spinal shrinkage in unloaded and loaded drop-jumping. Ergonomics 1994;37(1):133–139.PubMedGoogle Scholar
- 47.Reilly T, Chana D. Spinal shrinkage in fast bowling. Ergonomics 1994;37(1):127–132.PubMedGoogle Scholar
- 48.Nachemson A. Lumbar intradiscal pressure. Acta Orthop Scand 1960;40:1077–1092.Google Scholar
- 49.Ramos G, Martin W. Effects of vertebral axial decompression on intradiscal pressure. J Neurosurg 1994;81(3):350–353.PubMedCrossRefGoogle Scholar
- 50.Boscardin JB, Ringus JC, Feingold DJ, Ruda SC. Human intradiscal levels with cefazolin. Spine 1992;17(6 suppl):S145–S148.PubMedGoogle Scholar
- 51.Minami T, Hashii K, Tateyama I, Kadota E, Tohno Y, Tohno S, Utsumi M, Yamada MO, Ichii M, Namikawa K, et al. Accumulation of platinum in the intervertebral discs and vertebrae of ovarian tumor-bearing patients treated with cisplatin. Biol Trace Elem Res 1994;42(3):253–257.PubMedCrossRefGoogle Scholar
- 52.Rausing A, Rosen U. Black cartilage after therapy with levodopa and methyldopa. Arch Pathol Lab Med 1994;118(5):531–535.PubMedGoogle Scholar
- 53.Ohshima H, Urban JP. The effect of lactate and pH on proteoglycan and protein synthesis rates in the intervertebral disc. Spine 1992;17(9):1079–1082.PubMedGoogle Scholar
- 54.Holm S, Maroudas A, Urban JPG, Selstam G, Nachemson A. Nutrition of the intervertebral disc: solute transport and metabolism. Connect Tissue Res 1981;8:101–119.PubMedCrossRefGoogle Scholar
- 55.Urban JPG, Holm S, Maroudas A, Nachemson A. Nutrition of the intervertebral disc: effect of fluid flow on solute transport. Clin Orthop 1982;170:296–302.PubMedGoogle Scholar
- 56.Ohshima H, Urban JP, Bergel DH. Effect of static load on matrix synthesis rates in the intervertebral disc measured in vitro by a new perfusion technique. J Orthop Res 1995;13(1):22–29.PubMedCrossRefGoogle Scholar
- 57.Kaapa E, Holm S, Han X, Takala T, Kovanen V, Vanharanta H. Collagens in the injured porcine intervertebral disc. J Orthop Res 1994;12(1):93–102.PubMedCrossRefGoogle Scholar
- 58.Kaapa E, Han S, Holm S, Peltonen J, Takala T, Vanharanta H. Collagen synthesis and types I, III, IV, VI collagens in an animal model of disc degeneration. Spine 1995;20(1):59–65.PubMedGoogle Scholar
- 59.Kaapa E, Zhang LQ, Muona P, Holm S, Vanharanta H, Peltonen J. Expression of type I, III, and VI collagen mRNAs in experimentally injured porcine intervertebral disc. Connect Tissue Res 1994; 30(3):203–214.PubMedGoogle Scholar
- 60.Ziran BH, Pineda S, Pokharna H, Esteki A, Mansour JM, Moskowitz RW. Biomechanical, radiologic, and histopathologic correlations in the pathogenesis of experimental intervertebral disc disease. Spine 1994;19(19):2159–2163.PubMedGoogle Scholar
- 61.Osti OL, Vernon-Roberts B, Fraser RD. 1990 Volvo Award in experimental studies. Annulus tears and intervertebral disc degeneration. An experimental study using an animal model. Spine 1990;15:762–767.PubMedGoogle Scholar
- 62.Laible JP, Pflaster DS, Krag MH, Simon BR, Haugh LD. A poroelastic-swelling finite element model with application to the intervertebral disc. Spine 1993;18(5):659–670.PubMedGoogle Scholar
- 63.Natarajan RN, Ke JH, Andersson GB. A model to study the disc degeneration process. Spine 1994;19(3):259–265.PubMedGoogle Scholar
- 64.Kim YE, Goel VK, Weinstein JN, Lim TH. Effect of disc degeneration at one level on the adjacent level in axial mode. Spine 1991; 16(3):331–335.PubMedGoogle Scholar
- 65.Shirazi-Adl A. Finite-element simulation of changes in the fluid content of human lumbar discs. Mechanical and clinical implica-tions. Spine 1992;17(2):206–212.PubMedGoogle Scholar
- 66.Keller TS, Holm SH, Hansson TH, Spengler DM. 1990 Volvo Award in experimental studies. The dependence of intervertebral disc mechanical properties on physiologic conditions. Spine 1990;15(8): 751–761.PubMedGoogle Scholar
- 67.McNally DS, Adams MA, Goodship AE. Can intervertebral disc prolapse be predicted by disc mechanics? Spine 1993;18(11):1525–1530.PubMedGoogle Scholar
- 68.Ito S, Yamada Y, Tsuboi S, Yamada Y, Muro T. An observation of ruptured annulus fibrosus in lumbar discs. J Spinal Disord 1991;4(4): 462–466.PubMedGoogle Scholar
- 69.Gordon SJ, Yang KH, Mayer PJ, Mace AH Jr, Kish VL, Radin EL. Mechanism of disc rupture. A preliminary report. Spine 1991;16(4): 450–456.PubMedGoogle Scholar
- 70.Adams M. Laboratory model of lumbar disc protrusion: fissure and fragment. Spine 1994;19(17):2015–2017.PubMedGoogle Scholar
- 71.Brinckmann P, Porter RW. A laboratory model of lumbar disc protrusion. Fissure and fragment. Spine 1994;19(2):228–235.PubMedGoogle Scholar
- 72.Farfan HF, Cosette JW, Robertson GH, Wells RV, Kraus H. The effects of torsion on the lumbar intervertebral joints: the role of torsion in the production of disc degeneration. J Bone Joint Surg Am 1970;52:468–497.PubMedGoogle Scholar
- 73.Hagg O, Wallner A. Facet joint asymmetry and protrusion of the intervertebral disc. Spine 1990;15(5):356–359.PubMedGoogle Scholar
- 74.Cassidy JD, Loback D, Yong-Hing K, Tchang S. Lumbar facet joint asymmetry. Intervertebral disc herniation. Spine 1992;17(5):570–574.PubMedGoogle Scholar
- 75.Duncan NA, Ahmed AM. The role of axial rotation in the etiology of unilateral disc prolapse. An experimental and finite-element analysis. Spine 1991;16(9):1089–1098.PubMedGoogle Scholar
- 76.Puustjarvi K, Lammi M, Helminen H, Inkinen R, Tammi M. Proteoglycans in the intervertebral disc of young dogs following strenuous running exercise. Connect Tissue Res 1994;30(3):225–240.PubMedGoogle Scholar
- 77.Hambly MF, Mooney V. Effect of smoking and pulsed electromagnetic fields on intradiscal pH in rabbits. Spine 1992;17(6 suppl): S83–S85.PubMedGoogle Scholar
- 78.Nachemson A. Intradiscal measurements of pH in patients with lumbar rhizopathies. Acta Orthop Scand 1969;40:23–42.PubMedCrossRefGoogle Scholar
- 79.Yoo JU, Papay RS, Malemud CJ. Suppression of proteoglycan synthesis in chondrocyte cultures derived from canine intervertebral disc. Spine 1992;17(2):221–224.PubMedGoogle Scholar
- 80.Olczyk K. Age-related changes of elastin content in human intervertebral discs. Folia Histochem Cytobiol 1994;32(1):41–44.PubMedGoogle Scholar
- 81.Oda J, Tanaka H, Tsuzuki N. Intervertebral disc changes with aging of human cervical vertebrae, from the neonate to the eighties. Spine 1988;13:1205–1211.PubMedGoogle Scholar
- 82.Bernick S, Walker JM, Paule WJ. Age changes to the anulus fibrosus in human intervertebral discs. Spine 1991;16(5):520–524.PubMedGoogle Scholar
- 83.Yasuma T, Arai K, Suzuki F. Age-related phenomena in the lumbar intervertebral discs. Lipofuscin and amyloid deposition. Spine 1992;17(10):1194–1198.PubMedGoogle Scholar
- 84.Osti OL, Vernon-Roberts B, Fraser RD. Annular tears and disc degeneration in the lumbar spine. J Bone Joint Surg Br 1992;74:678–682.PubMedGoogle Scholar
- 85.Vasan NS, Gutteling EW, Lee CK, Cibischino M, Parsons JR. A preliminary study of mechanically stress-induced changes in the ex-tracellular matrix of the canine intervertebral disc. Spine 1991;16(3): 317–320.PubMedGoogle Scholar
- 86.Mimura M, Panjabi MM, Oxland TR, Crisco JJ, Yamamoto I, Vasavada A. Disc degeneration affects the multidirectional flexibility of the lumbar spine. Spine 1994;19(12):1371–1380.PubMedGoogle Scholar
- 87.Tanaka M, Nakahara S, Inoue H. A pathologic study of discs in the elderly. Separation between the cartilaginous endplate and the vertebral body. Spine 1993;18(11):1456–1462.PubMedGoogle Scholar
- 88.Butler D, Trafimow JH, Andersson GB, McNeill TW, Huckman MS. Discs degenerate before facets. Spine 1990;15(2):111–113.PubMedGoogle Scholar
- 89.Noren R, Trafimow J, Andersson GB, Huckman MS. The role of facet joint tropism and facet angle in disc degeneration. Spine 1991;16(5):530–532.PubMedGoogle Scholar
- 90.Matsui H, Terahata N, Tsuji H, Hirano N, Naruse Y. Familial predisposition and clustering for juvenile lumbar disc herniation. Spine 1992;17(11):1323–1328.PubMedGoogle Scholar
- 91.Matsui H, Tsuji H, Terahata N. Juvenile lumbar herniated nucleus pulposus in monozygotic twins. Spine 1990;15(11):1228–1130.PubMedGoogle Scholar
- 92.Heliovaara M. Risk factors for low back pain and sciatica. Ann Med 1989;21(4):257–264.PubMedGoogle Scholar
- 93.Lotz JC, Colliou OK, Chin JR, Duncan NA, Liebenberg E. Compression-induced degeneration of the intervertebral disc: an in vivo mouse model and finite-element study. Spine 1998;23(23):2493–2506.PubMedCrossRefGoogle Scholar
- 94.Kawaguchi Y, Osada R, Kanamori M, Ishihara H, Ohmori K, Matsui H, Kimura T. Association between an aggrecan gene polymorphism and lumbar disc degeneration. Spine 1999;24(23):2456–2460.PubMedCrossRefGoogle Scholar
- 95.Heikkila JK, Koskenvuo M, Heliovaara M, Kurppa K, Riihimaki H, Heikkila K, Rita H, Videman T. Genetic and environmental factors in sciatica. Evidence from a nationwide panel of 9365 adult twin pairs. Ann Med 1989;21(5):393–398.PubMedGoogle Scholar
- 96.Videman T, Leppavuori J, Kaprio J, Battie MC, Gibbons LE, Peltonen L, Koskenvuo M. Intragenic polymorphisms of the vitamin D receptor gene associated with intervertebral disc degeneration. Spine 1998;23(23):2477–2485.PubMedCrossRefGoogle Scholar
- 97.Paassilta P, Lohiniva J, Goring HH, Perala M, Raina SS, Karppinen J, Hakala M, Palm T, Kroger H, Kaitila I, Vanharanta H, Ott J, AlaKokko I. Identification of a novel common genetic risk factor for lumbar disk disease. JAMA 2001;285(14):1843–1849.PubMedCrossRefGoogle Scholar
- 98.Annunen S, Paassilta P, Lohiniva J, Perala M, Pihlajamaa T, Karppinen J, Tervonen O, Kroger H, Lahde S, Vanharanta H, Ryhanen L, Goring HH, Ott J, Prockop DJ, Ala-Kokko L. An allele of COL9A2 associated with intervertebral disc disease. Science 1999;285(5426): 409–412.PubMedCrossRefGoogle Scholar
- 99.van der Rest M, Garrone R. Collagen family of proteins. Faseb J 1991;5(13):2814–2823.PubMedGoogle Scholar
- 100.van der Rest M, Aubert-Foucher E, Dublet B, Eichenberger D, Font B, Goldschmidt D. Structure and function of the fibril-associated collagens. Biochem Soc Trans 1991;19(4):820–824.PubMedGoogle Scholar
- 101.Diab M. The role of type IX collagen in osteoarthritis and rheumatoid arthritis. Orthop Rev 1993;22(2):165–170.PubMedGoogle Scholar
- 102.Eyre D. Collagen cross-linking amino acids. Methods Enzymol 1987;144:115-139.Google Scholar
- 103.Eyre DR, Apon S, Wu JJ, Ericsson LH, Walsh KA. Collagen type IX: evidence for covalent linkages to type II collagen in cartilage. FEBS Lett 1987;220(2):337–341.PubMedCrossRefGoogle Scholar
- 104.Diab M, Wu JJ, Eyre DR. Collagen type IX from human cartilage: a structural profile of intermolecular cross-linking sites. Biochem J 1996;314(Pt 1):327–332.PubMedGoogle Scholar
- 105.Pihlajamaa T, Perala M, Vuoristo MM, Nokelainen M, Bodo M, Schulthess T, Vuorio E, Timpl R, Engel J, Ala-Kokko L. Characterization of recombinant human type IX collagen. Association of alpha chains into homotrimeric and heterotrimeric molecules. J Biol Chem 1999;274(32):22464–22468.PubMedCrossRefGoogle Scholar
- 106.Bonnemann CG, Cox GF, Shapiro F, Wu JJ, Feener CA, Thompson TG, Anthony DC, Eyre DR, Darras BT, Kunkel LM. A mutation in the alpha 3 chain of type IX collagen causes autosomal dominant multiple epiphyseal dysplasia with mild myopathy. Proc Natl Acad Sci USA 2000;97(3):1212–1217.PubMedCrossRefGoogle Scholar
- 107.Kauppila LI, Penttila A, Karhunen PJ, Lalu K, Hannikainen P. Lumbar disc degeneration and atherosclerosis of the abdominal aorta. Spine 1994;19(8):923–929.PubMedGoogle Scholar
- 108.Hoyland JA, Freemont AJ, Jayson MIV. Intervertebral foramen venous obstruction. A cause of periradicular fibrosis? Spine 1989;14:558.PubMedGoogle Scholar
- 109.Holm S, Nachemson A. Nutrition of the intervertebral disc. Acute effects of smoking. Uppsala J Med Sci 1988;93:91–99.Google Scholar
- 110.McDevitt CA, Beck GJ, Ciunga MJ, O’Brien J. Cigarette smoking degrades hyaluronic acid. Lung 1985;167:237–245.Google Scholar
- 111.Battie MC, Videman T, Gill K, Moneta GB, Nyman R, Kaprio J, Koskenvuo M. 1991 Volvo Award in clinical sciences. Smoking and lumbar intervertebral disc degeneration: an MRI study of identical twins. Spine 1991;16(9):1015–1021.PubMedGoogle Scholar
- 112.Ishihara H, Tsuji H, Hirano N, Ohshima H, Terahata N. Effects of continuous quantitative vibration on rheologic and biological behaviors of the intervertebral disc. Spine 1992;17(3 suppl):S7–S12.PubMedGoogle Scholar
- 113.Pedrini-Mille A, Weinstein JN, Found EM, Chung CB, Goel VK. Stimulation of dorsal root ganglia and degradation of rabbit annulus fibrosus. Spine 1990;15(12):1252–1256.PubMedGoogle Scholar
- 114.Sward L, Hellstrom M, Jacobsson B, Nyman R, Peterson L. Acute injury of the vertebral ring apophysis and intervertebral disc in adolescent gymnasts. Spine 1990;15(2):144–148.PubMedGoogle Scholar
- 115.Sward L, Hellstrom M, Jacobsson B, Nyman R, Peterson L. Disc degeneration and associated abnormalities of the spine in elite gymnasts. A magnetic resonance imaging study. Spine 1991;16(4): 437–443.PubMedGoogle Scholar
- 116.Boutin P, Hogshead H. Surgical pathology of the intervertebral disc. Is routine examination necessary? Spine 1992;17(10):1236–1238.PubMedGoogle Scholar
- 117.el-Hefnawy M, Yehia A, Farahat HM, el-Feky H, Mangoud AM, Aly MA, Essia MH, Abdel-Wahab RM. Extruded and protruded lumbar discs: combined clinical, histopathological, histochemical, immunopathological, histochemical, immunopathological and ultrastructural studies. J Egypt Public Health Assoc 1991;66(5–6):519–543.PubMedGoogle Scholar
- 118.Brock M, Patt S, Mayer HM. The form and structure of the extruded disc. Spine 1992;17(12):1457–1461.PubMedCrossRefGoogle Scholar
- 119.Lipson SJ. Metaplastic proliferative fibrocartilage as an alternative concept to the herniated disc. Spine 1988;13:1055–1060.PubMedGoogle Scholar
- 120.Johnstone B, Urban JP, Roberts S, Menage J. The fluid content of the human intervertebral disc. Comparison between fluid content and swelling pressure profiles of discs removed at surgery and those taken postmortem. Spine 1992;17(4):412–416.PubMedGoogle Scholar
- 121.Chitkara YK. Clinicopathologic study of changes in prolapsed intervertebral disks. Arch Pathol Lab Med 1991;115(5):481–483.PubMedGoogle Scholar
- 122.Hirabayashi S, Kumano K, Tsuiki T, Eguchi M, Ikeda S. A dorsally displaced free fragment of lumbar disc herniation and its interesting histologic findings. A case report. Spine 1990;15(11):1231–1233.PubMedGoogle Scholar
- 123.Yamashita K, Hiroshima K, Kurata A. Gadolinium-DTPA-enhanced magnetic resonance imaging of a sequestered lumbar intervertebral disc and its correlation with pathologic findings. Spine 1994;19(4):479–482.PubMedGoogle Scholar
- 124.Weinstein JN, Claverie W, Gibson S. The pain of discography. Spine 1988;13:1344–1348.PubMedGoogle Scholar
- 125.Spencer DL, Mailler JA, Bertolini JE. The effect of intervertebral disc space narrowing on the contact force between the nerve root and a simulated disc protrusion. Spine 1984;9:422–426.PubMedGoogle Scholar
- 126.Garfin SR, Rydevik BL, Brown RA. Compressive neuropathy of spinal nerve roots. A mechanical or biological problem? Spine 1991;16(2):162–166.PubMedGoogle Scholar
- 127.Olmarker K, Rydevik B, Holm S, Bagge U. Effects of experimental graded compression on blood-flow in spinal nerve roots. J Orthop Res 1989;7:817–823.PubMedCrossRefGoogle Scholar
- 128.Lind B, Massie JB, Lincoln T, Myers RR, Swenson MR, Garfin SR. The effects of induced hypertension and acute graded compression on impulse propagation in the spinal nerve roots of the pig. Spine 1993;18(11):1550–1555.PubMedCrossRefGoogle Scholar
- 129.Naftulin S, Fast A, Thomas M. Diabetic lumbar radiculopathy: sciatica without disc herniation. Spine 1993;18(16):2419–2422.PubMedGoogle Scholar
- 130.Hasue M. Pain and the nerve root. An interdisciplinary approach. Spine 1993;18(14):2053–2058.PubMedGoogle Scholar
- 131.McCarron RF, Wimpee MW, Hudkins PG, Laros GS. The inflammatory effect of nucleus pulposus: a possible element in the pathogenesis of low back pain. Spine 1987;10:134–137.Google Scholar
- 132.Marshall LL, Treththewie ER, Curtain CC. Chemical radiculitis. Clin Orthop 1977;129:61–67.PubMedGoogle Scholar
- 133.Spiliopoulou I, Korovessis P, Konstantinou D, Dimitracopoulos G. IgG and IgM concentration in the prolapsed human intervertebral disc and sciatica etiology. Spine 1994;19(12):1320–1323.PubMedGoogle Scholar
- 134.Bobechko WP, Hirsch C. Autoimmune response to nucleus pulposus in the rabbit. J Bone Joint Surg Br 1965;47:574–580.PubMedGoogle Scholar
- 135.Franson RC, Saal JS, Saal JA. Human disc phospholipase A2 is inflammatory. Spine 1992;17(6 suppl):S129–S132.PubMedGoogle Scholar
- 136.Saal JS, Franson RC, Dobrow R, Saal JA, White AH, Goldthwaite N. High levels of inflammatory phospholipase A2 activity in lumbar disc herniations. Spine 1990;15(7):674–678.PubMedGoogle Scholar
- 137.Willburger RE, Wittenberg RH. Prostaglandin release from lumbar disc and facet joint tissue. Spine 1994;19(18):2068–2070.PubMedGoogle Scholar
- 138.Skouen JS, Larsen JL, Vollset SE. Cerebrospinal fluid proteins as indicators of nerve root compression in patients with sciatica caused by disc herniation. Spine 1993;18(1):72–79.PubMedGoogle Scholar
- 139.Pettersson CA. Drainage of molecules from subarachnoid space to spinal nerve roots and peripheral nerve of the rat. A study based on Evans blue—albumin and lanthanum as tracers. Acta Neuropathol Berl 1993;86(6):636–644.PubMedCrossRefGoogle Scholar
- 140.Yu S, Haughton VM, Sether LA, Wagner M. Annulus fibrosus in bulging intervertebral discs. Radiology 1988;169:761–763.PubMedGoogle Scholar
- 141.Peyster RG, Teplick JG, Haskin ME. Computed tomography of lumbosacral conjoined nerve root anomalies. Potential cause of false positive reading for herniated nucleus pulposus. Spine 1985;10:331–337.PubMedGoogle Scholar
- 142.Epstein NE, Epstein JA, Carras R, Hyman RA. Far lateral lumbar disc herniations and associated structural abnormalities. An evaluation in 60 patients of the comparative value of CT, MRI, and myelo-CT in diagnosis and management. Spine 1990;15(6):534–539.PubMedGoogle Scholar
- 143.Chatani K, Kusaka Y, Mifune T, Nishikawa H. Topographic differences of 1H-NMR relaxation times T1, T2 in the normal intervertebral disc and its relationship to water content. Spine 1993;18(15): 2271–2275.PubMedGoogle Scholar
- 144.Castagnera L, Grenier N, Lavignolle B, Greselle JF, Senegas J, Caille JM. Study of correlation between intradiscal pressure and magnetic resonance imaging data in evaluation of disc degeneration. Therapeutic issue with percutaneous nucleotomy. Spine 1991;16(3):348–352.PubMedGoogle Scholar
- 145.Tertti M, Paajanen H, Laato M, Aho H, Komu M, Kormanc M. Disc degeneration in magnetic resonance imaging. A comparative biochemical, histologic, and radiologic study in cadaver spines. Spine 1991;16(6):629–634.PubMedGoogle Scholar
- 146.Schiebler ML, Camerino VJ, Fallon MD, Zlatkin MB, Grenier N, Kressel HY. In vivo and ex vivo magnetic resonance imaging evaluation of early disc degeneration with histopathologic correlation. Spine 1991;16(6):635–640.PubMedGoogle Scholar
- 147.Gunzburg R, Parkinson R, Moore R, Cantraine F, Hutton W, Vernon-Roberts B, Fraser R. A cadaveric study comparing discography, magnetic resonance imaging, histology, and mechanical behavior of the human lumbar disc. Spine 1992;17(4):417–426.PubMedGoogle Scholar
- 148.Heggeness MH, Doherty BJ. Discography causes end plate deflection. Spine 1993;18(8):1050–1053.PubMedGoogle Scholar
- 149.Executive committee of the North American Spine Society. Position statement on discography. Spine 1988;13(12):1343.Google Scholar
- 150.Nachemson A. Lumbar discography—where are we today? Spine 1989;14(6):555–557.PubMedGoogle Scholar
- 151.Lord P. Definitions of disc disease [letter; comment]. Br J Hosp Med 1991;46(3):142.PubMedGoogle Scholar
- 152.Breton G. Is that a bulging disk, a small herniation or a moderate protrusion? [editorial; comment]. Can Assoc Radiol J 1991;42(5):318.PubMedGoogle Scholar
- 153.Milette PC. Radiculopathy, radicular pain, radiating pain, referred pain. What are we really talking about? [letter; comment]. Radiology 1994;192(1):280–282.PubMedGoogle Scholar
- 154.Fardon D, Pinkerton S, Balderston R, Garfin S, Nasca R, Salib R. Terms used for diagnosis by English-speaking spine surgeons. Spine 1993;18(2):274–277.PubMedGoogle Scholar
- 155.Thelander U, Fagerlund M, Friberg S, Larsson S. Describing the size of lumbar disc herniations using computed tomography. A comparison of different size index calculations and their relation to sciatica. Spine 1994;19(17):1979–1984.PubMedGoogle Scholar
- 156.Thompson JP, Pearce RH, Schechter MT, Adams ME, Tsang IK, Bishop PB. Preliminary evaluation of a scheme for grading the gross morphology of the human intervertebral disc. Spine 1990; 15(5):411–415.PubMedGoogle Scholar
- 157.Adams MA, Dolan P, Hutton WC. The stages of disc degeneration as revealed by discograms. J Bone Joint Surg Br 1986;68:36–41.PubMedGoogle Scholar
- 158.Brinckmann P, Grootenboer H. Change of disc height, radial disc bulge, and intradiscal pressure from discectomy. An in vitro investigation on human lumbar discs. Spine 1991;16(6):641–646.PubMedGoogle Scholar
- 159.Smith JW, Walmsley R. Experimental incision of the intervertebral disc. J Bone Joint Surg Br 1951;33:12–25.Google Scholar
- 160.Ahlgren BD, Vasavada A, Brower RS, Lydon C, Herkowitz HN, Panjabi MM. Anular incision technique on the strength and multidirectional flexibility of the healing intervertebral disc. Spine 1994;19(8):948–954.PubMedGoogle Scholar
- 161.Songer MN, Ghosh L, Spencer DL. Effects of sodium hyaluronate on peridural fibrosis after lumbar laminotomy and discectomy. Spine 1990;15(6):550–554.PubMedGoogle Scholar
- 162.Jayson MIV. The role of vascular damage and fibrosis in the pathogenesis of nerve root damage. Clin Orthop 1992;279:40–48.PubMedGoogle Scholar
- 163.Hoyland JA, Freemont AJ, Denton J, Thomas AMC, McMillan JJ, Jayson MIV. Retained surgical swab debris in postlaminectomy arachnoiditis and peridural fibrosis. J Bone Joint Surg Br 1988;70:659.PubMedGoogle Scholar
- 164.Kawakami M, Weinstein JN, Spratt KF, Chatani K, Traub RJ, Meller ST, Gebhart GF. Experimental lumbar radiculopathy. Immunohistochemical and quantitative demonstrations of pain induced by lumbar nerve root irritation of the rat. Spine 1994;19(16):1780–1794.PubMedCrossRefGoogle Scholar