Pathophysiology of degenerative spinal disease causing lumbar and cervical spinal pain.
10.5124/jkma.2014.57.4.300
- Author:
In Sik LEE
1
;
Sun G CHUNG
Author Information
1. Department of Rehabilitation Medicine, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Korea.
- Publication Type:Original Article
- Keywords:
Intervetebral disc degeneration;
Physiopathology;
Low back pain;
Neck pain;
Spinal stenosis
- MeSH:
Intervertebral Disc;
Low Back Pain;
Neck Pain;
Posture;
Risk Factors;
Spinal Diseases*;
Spinal Stenosis;
Spine;
Zygapophyseal Joint
- From:Journal of the Korean Medical Association
2014;57(4):300-307
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
As degenerative spinal disease among spinal diseases causing lumbar and cervical spinal pain is the endless repetition of "the biological healing of mechanical damage" occurring over a lifetime, spinal pain by degenerative spinal disease occurs as a series of successive changes through the repetitive damage-healing process of various spinal structures including the intervertebral disc rather than a temporary phenomenon of any given pathophysiologic change in one moment. Degenerative spinal disease generally begins with degeneration of the intervertebral disc. Then herniation of the intervertebral disc resulting in subsequent radicular pain occurs when the nucleus pulposus with degeneration located in the intervertebral disc tears and penetrates the annulus fibrosus. Subsequently, disc space narrowing occurs and alters the spinal biomechanics, followed by degenerative changes to the vertebral endplate, vertebra itself, and facet joint. Finally, these changes lead to spinal stenosis, which is the final destination of degenerative spine disease. Although the exact pathogenesis of spinal pain could be still unclear because of some inconsistencies between the degenerative changes in the spine and the clinical manifestations of spinal pain, an accurate understanding of the pathophysiology and future predictions for further mechanical injury as well as thorough history taking and careful attention to the long-term clinical courses and other associated risk factors including daily life posture and work posture are needed for successful treatment of spinal pain.
