The biomechanics and biochemistry of disc degeneration

Low back pain is a major cause of economic and emotional suffering in industrialized countries. The intervertebral disc continues to be a structure of great interest because its degeneration or failure may influence a variety of structures and processes believed to play a role in pain production. Recent work has led to an increased understanding of the biomechanics and biochemistry of disc degeneration, as well as their interaction. Much of the understanding of disc degeneration has focused on changes in disc properties and the relationship of these changes to the biomechanical properties of the disc. Recent work, however, has begun to clearly demonstrate that there is a fundamental interaction between the biochemistry of a degenerating disc and its function. The future area of emphasis will continue to be in the biologic arena, especially as the genetic secrets of the intervertebral disc continue to be unlocked.Curr Opin Orthop 1999, 10:117–121 © Lippincott Williams & Wilkins, Inc.