椎间盘结构异常类型及相关机械载荷与生物力学因素.

BACKGROUND: The problem of intervertebral disc injury and degeneration has been studied in many ways. Many studies have shown that intervertebral disc injury and degeneration is driven by mechanical loading factors. However, the potential relationship between common phenotypes of intervertebral disc injury and degeneration and mechanical loading factors has been rarely summarized. OBJECTIVE: To summarize the types of common structural abnormalities exhibited by intervertebral disc injury and degeneration in the published literature, and sum up the potential links to the types of mechanical loading that lead to these structural abnormalities in in vitro and ex vivo experimental studies. METHODS: Using the terms “intervertebral disc failure, intervertebral disc injury, mechanical load, mechanical factor, load factor, biomechanics” as Chinese and English key words in PubMed, CNKI, and WanFang databases, articles related to intervertebral disc injury degeneration and mechanical load factors were retrieved. Literature screening was performed according to the inclusion and exclusion criteria, and 88 articles were finally included. RESULTS AND CONCLUSION: (1) Common structural abnormalities of intervertebral discs include decreased intervertebral disc height, disc bulge, osteophyte formation, annulus fibrosus tear, intervertebral disc herniation or disc prolapse, endplate damage, Schmorl nodes and intervertebral disc calcification. Intervertebral discs are susceptible to mechanical load types such as compression, bending, axial rotation, and compound loads. (2) The compressive load mainly causes the decrease of the proteoglycan content and the water-binding ability of the intervertebral disc, leading to the decrease or swelling of the intervertebral disc and further damage and degeneration of the intervertebral disc. In addition, the excessive compressive load causes greater damage to the endplate. (3) Bending load and axial rotation load damage the annulus fibrosus more than the endplate, and prolonged or repeated bending loads can cause tearing of the fibrous annulus and herniation or prolapse of the intervertebral disc, while pure axial rotation loads can induce less damage to the intervertebral disc and only cause the tear of the annulus fibrosus. (4) However, when different load types act in combination, it is more likely to result in high stress on the disc and a greater risk of disc injury. (5) Injury and degeneration of the intervertebral disc present progressive structural damage, and early prevention and protection are particularly important in clinical practice. Future tissue engineering research can start with early repair of the intervertebral disc. [ABSTRACT FROM AUTHOR]