Back pain is an important problem that affects two-thirds of adults at some time in their lives. One of the leading causes of functional incapacity is spinal degeneration, which is a common source of chronic disability in the working population. Traditionally, disk degeneration has been linked to mechanical loading. Disk failure is more common in areas of the back subject to the heaviest mechanical stresses, such as the lower lumbar region. It has been suggested that mechanical factors produce endplate damage . The disk is metabolically active, and its metabolism is dependent on the diffusion of fluid, either from the marrow across the subchondral bone and cartilaginous endplate or through the annulus fibrosus from the surrounding blood vessels. Morphological changes in the vertebral bone and cartilaginous endplate, which occur with advancing age or degeneration, can interfere with normal disk nutrition and further the degenerative process . As degeneration progresses, structures of the disk become increasingly disarranged such that greater stresses are placed on the annulus and facet joint.
KeywordsNerve Root Intervertebral Disk Nucleus Pulposus Facet Joint Spinal Stenosis
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