Disc DDx

“Surprise” Loading in Flexion Increases the Risk of Disc Herniation Due to Annulus-Endplate Junction Failure: A Mechanical and Microstructural Investigation.


2009 ISSLS Prize Winner: Does discography cause accelerated progression of degeneration changes in the lumbar disc: a ten-year matched cohort study.

A comprehensive review of the sinuvertebral nerve with clinical applications.

Shayota B, Wong TL, Fru D, David G, Iwanaga J, Loukas M, Tubbs RS. Anat Cell Biol. 2019 Jun;52(2):128-133. doi: 10.5115/acb.2019.52.2.128.

A review of microscopy-based evidence for the association of Propionibacterium acnes biofilms in degenerative disc disease and other diseased human tissue.

Capoor MN, Birkenmaier C, Wang JC, McDowell A, Ahmed FS, Brüggemann H, Coscia E, Davies DG, Ohrt-Nissen S, Raz A, Ruzicka F, Schmitz JE, Fischetti VA, Slaby O. Eur Spine J. 2019 Jul 29. doi: 10.1007/s00586-019-06086-y.

Accumulation and localization of macrophage phenotypes with human intervertebral disc degeneration

Kenneth R. Nakazawa, Benjamin A. Walter, Damien M. Laudier, Divya Krishnamoorthy, Grace E. Mosley, Kara L. Spiller, James C. Iatridis. The Spine Journal. October 11, 2017. DOI:10.1016/j.spinee.2017.09.018

Active discopathy: a clinical reality.

Boisson M, Lefèvre-Colau MM, Rannou F, Nguyen C. RMD Open. 2018 Apr 17;4(1):e000660. doi: 10.1136/rmdopen-2018-000660.

Aging changes in lumbar discs and vertebrae and their interaction: a 15-year follow-up study.


Analysis of Migration Patterns of Disk Fragments and Contributing Factors in Extruded Lumbar Disk Herniation.

Son ES, Kim DH, Jung JW, Lee D. PM R. 2016 Jun 16. pii: S1934-1482(16)30183-6. doi: 10.1016/j.pmrj.2016.06.007.

Analysis of the influence of disc degeneration on the mechanical behaviour of a lumbar motion segment using the finite element method.


Annulus fibrosus cells express and utilize C-C chemokine receptor 5 (CCR5) for migration.

Liu W, Liu D, Zheng J, Shi P, Chou PH, Oh C, Chen D, An HS, Chee A. Spine J. 2017 Jan 17. pii: S1529-9430(17)30022-0. doi: 10.1016/j.spinee.2017.01.010

Are lumbar multifidus fatigue and transversus abdominis activation similar in patients with lumbar disc herniation and healthy controls? A case control study.

Ramos LA, França FJ, Callegari B, Burke TN, Magalhães MO, Marques AP. Eur Spine J. 2016 May

Are modic changes associated with intervertebral disc cytokine profiles?

Schroeder GD, Markova DZ, Koerner JD, Rihn JA, Hilibrand AS, Vaccaro AR, Anderson DG, Kepler CK. Spine J. 2016 Aug

Associations between intervertebral disc degeneration grading schemes and measures of disc function.

Zehra U, Noel-Barker N, Marshall J, Adams MA, Dolan P. J Orthop Res. 2019 May 1. doi: 10.1002/jor.24326.

Bacteria: back pain, leg pain and Modic sign-a surgical multicentre comparative study.

Fritzell P, Welinder-Olsson C, Jönsson B, Melhus Å, Andersson S, Bergström T, Tropp H, Gerdhem P, Hägg O, Laestander H, Knutsson B, Lundin A, Ekman P, Rydman E, Skorpil M. Eur Spine J. 2019 Oct 1. doi: 10.1007/s00586-019-06164-1.

Cartilage Endplate Thickness Variation Measured by Ultrashort Echo-Time MRI Is Associated with Adjacent Disc Degeneration.

Berg-Johansen B, Han M, Fields AJ, Liebenberg EC, Lim BJ, Larson PE, Gunduz-Demir C, Kazakia GJ, Krug R, Lotz JC. Spine (Phila Pa 1976). 2017 Oct 3. doi: 10.1097/BRS.0000000000002432.

Changes in Lumbar Endplate Area and Concavity Associated With Disc Degeneration.

Louie PK, Espinoza Orías AA, Fogg LF, LaBelle M, An HS, Andersson GBJ, Inoue N. Spine (Phila Pa 1976). 2018 Mar 27. doi: 10.1097/BRS.0000000000002657.

Clinical Presentation and Outcomes of Patients With a Lumbar Far Lateral Herniated Nucleus Pulposus as Compared to Those With a Central or Paracentral Herniation

Jannat M Khan et al. Global Spine Journal. November 18, 2018. Doi: 10.1177/2192568218800055

Comparison of Modic Changes in the Lumbar and Cervical Spine, in 3167 Patients with and without Spinal Pain


Comparison of MRI cross-sectional area and functions of core muscles among asymptomatic individuals with and without lumbar intervertebral disc degeneration

Gyeong-tae Gwak, Ui-jae Hwang, Sung-hoon Jung, Hyun-a Kim, Jun-hee Kim and Oh-yun Kwon. BMC Musculoskeletal Disorders 2019 20:576. 1 December 2019. DOI: 10.1186/s12891-019-2960-y

CT morphometry of adult thoracic intervertebral discs.


Current perspectives on the role of biomechanical loading and genetics in development of disc degeneration and low back pain; a narrative review

Jill P.G. Urban, Jeremy C.T. Fairbank. Journal of Biomechanics. 16 December 2019. DOI: 10.1016/j.jbiomech.2019.109573

Cytokine Involvement in Biological Inflammation Related to Degenerative Disorders of the Intervertebral Disk: A Narrative Review

Christopher M. De Geer. J Chiropractic Medicine. February 4, 2018. DOI: 10.1016/j.jcm.2017.09.003

Defects of the vertebral endplate: implications for disc degeneration depend on size.

Zehra U, Flower L, Robson-Brown K, Adams MA, Dolan P. Spine J. 2017 Jan 17. pii: S1529-9430(17)30019-0. doi: 10.1016/j.spinee.2017.01.007.

Disc degeneration induces a mechano-sensitization of disc afferent nerve fibers that associates with low back pain

Park EH, Moon SW, Suh HR, Hochman S, Lee MG, Kim YI, Jang IT, Han HC. Osteoarthritis Cartilage. 2019 Jul 18. pii: S1063-4584(19)31143-4. doi: 10.1016/j.joca.2019.07.010.

Disc degeneration induces a mechano-sensitization of disc afferent nerve fibers that associates with low back pain.

Park EH, Moon SW, Suh HR, Hochman S, Lee MG, Kim YI, Jang IT, Han HC. Osteoarthritis Cartilage. 2019 Jul 18. pii: S1063-4584(19)31143-4. doi: 10.1016/j.joca.2019.07.010.

Does Size Matter? An Analysis of the Effect of Lumbar Disc Herniation Size on the Success of Nonoperative Treatment

Anmol Gupta, BS, Shivam Upadhyaya, MD, Caleb M. Yeung, MD, Peter J. Ostergaard, MD, Harold A. Fogel, MD, Thomas Cha, MD, Joseph Schwab, MD, Chris Bono, MD, Stuart Hershman, MD. Global Spine Journal. October 10, 2019. DOI: 10.1177/2192568219880822

Dynamic Adaptation of Vertebral Endplate and Trabecular Bone following Annular Injury in a Rat Model of Degenerative Disc Disease

Tristan Maerz, Michael Newton, Abigail A. Marek, Michael Planalp, Kevin Baker. The Spine Journal. June 7, 2018. DOI: 10.1016/j.spinee.2018.05.045

Effect of disc degeneration on the mechanical behavior of the human lumbar spine: a probabilistic finite element study

Maxim Bashkuev, Sandra Reitmaier, Hendrik Schmidt. The Spine Journal. June 7, 2018. DOI: 10.1016/j.spinee.2018.05.046

Effects of Cervical Extension on Deformation of Intervertebral Disc and Migration of Nucleus Pulposus.

Kim YH, Kim SI, Park S, Hong SH, Chung SG. PM R. 2016 Sep 6. pii: S1934-1482(16)30905-4. doi: 10.1016/j.pmrj.2016.08.027

Evidence for a role of nerve injury in painful intervertebral disc degeneration: A cross-sectional proteomic analysis of human cerebrospinal fluid

Tony K.Y. Lim, Kathleen M. Anderson, Pawan Hari, Marcos Di Falco, Troy E. Reihsen, George L. Wilcox, Kumar G. Belani, Sylvie LaBoissiere, Manuel R. Pinto, David S. Beebe, Lois Kehl, Laura S. Stone. Journal of Pain. June 24, 2017. DOI:10.1016/j.jpain.2017.06.002

Evidence for a Role of Nerve Injury in Painful Intervertebral Disc Degeneration: A Cross-Sectional Proteomic Analysis of Human Cerebrospinal Fluid.

Lim TKY, Anderson KM, Hari P, Di Falco M, Reihsen TE, Wilcox GL, Belani KG, LaBoissiere S, Pinto MR, Beebe DS, Kehl LJ, Stone LS. J Pain. 2017 Oct;18(10):1253-1269. doi: 10.1016/j.jpain.2017.06.002.

Exploratory study for identifying systemic biomarkers that correlate with pain response in patients with intervertebral disc disorders.


Factors that influence neurological deficit and recovery in lumbar disc prolapse-a narrative review.

Nv A, Rajasekaran S, Ks SVA, Kanna RM, Shetty AP. Int Orthop. 2018 Nov 24. doi: 10.1007/s00264-018-4242-y.

Five-year development of lumbar disc degeneration-a prospective study.

Schistad EI, Bjorland S, Røe C, Gjerstad J, Vetti N, Myhre K, Espeland A. Skeletal Radiol. 2018 Sep 25. doi: 10.1007/s00256-018-3062-x.

Genetic Predisposition to Symptomatic Lumbar Disk Herniation in Pediatric and Young Adult Patients.

Theodore N, Ahmed AK, Fulton T, Mousses S, Yoo C, Goodwin CR, Danielson J, Sciubba DM, Giers MB, Kalani MYS. Spine (Phila Pa 1976). 2018 Nov 20. doi: 10.1097/BRS.0000000000002949.

Histomorphology and immunohistochemical patterns in degenerative disc disease and clinical-radiological correlations: a prospective study.

Miscusi M, Carnevali C, Ricciardi L, Miglietta S, Petrozza V, Cacciotti J, Calogero A, Rosa P, Familiari G, Raco A. Eur Spine J. 2020 Apr 16. doi: 10.1007/s00586-020-06412-9.

How healthy discs herniate: a biomechanical and microstructural study investigating the combined effects of compression rate and flexion.


Human cartilage endplate permeability varies with degeneration and intervertebral disc site.


Incidence of Spontaneous Resorption of Lumbar Disc Herniation: A Meta-Analysis.

Zhong M, Liu JT, Jiang H, Mo W, Yu PF, Li XC, Xue RR. Pain Physician. 2017 Jan-Feb;20(1):E45-E52.

Influence of Complex Loading Conditions on Intervertebral Disc Failure.

Berger-Roscher N, Casaroli G, Rasche V, Villa T, Galbusera F, Wilke HJ. Spine (Phila Pa 1976). 2017 Jan 15;42(2):E78-E85. doi: 10.1097/BRS.0000000000001699.

Ingrowth of Nociceptive Receptors into Diseased Cervical Intervertebral Disc Is Associated with Discogenic Neck Pain.

Wu B, Yang L, Peng B. Pain Med. 2019 Mar 8. pii: pnz013. doi: 10.1093/pm/pnz013.

Intervertebral disc status is associated with vertebral marrow adipose tissue and muscular endurance.

Quittner M, Rantalainen T, Ridgers ND, Trudel G, Sheikh A, Connell D, Belavý DL. Eur Spine J. 2018 Apr 6. doi: 10.1007/s00586-018-5567-3.

Intervertebral discs from spinal nondeformity and deformity patients have different mechanical and matrix properties.


Is an annular tear a predictor for accelerated disc degeneration?


Is infection the possible initiator of disc disease? An insight from proteomic analysis.

Rajasekaran S, Tangavel C, Aiyer SN, Nayagam SM, Raveendran M, Demonte NL, Subbaiah P, Kanna R, Shetty AP, Dharmalingam K. Eur Spine J. 2017 Feb 6. doi: 10.1007/s00586-017-4972-3.

Is smoking a risk factor for lumbar disc herniation?


ISSLS PRIZE IN BASIC SCIENCE 2020: Beyond microstructure-circumferential specialization within the lumbar intervertebral disc annulus extends to collagen nanostructure, with counterintuitive relationships to macroscale material properties

Herod TW, Veres SP. Eur Spine J. 2019 Nov 25. doi: 10.1007/s00586-019-06223-7.

Leptin and the intervertebral disc: a biochemical link exists between obesity, intervertebral disc degeneration and low back pain-an in vitro study in a bovine model.

Segar AH, Fairbank JCT, Urban J. Eur Spine J. 2018 Oct 15. doi: 10.1007/s00586-018-5778-7.

Looking beyond the intervertebral disc: the need for behavioral assays in models of discogenic pain.

Mosley GE, Evashwick-Rogler TW, Lai A, Iatridis JC. Ann N Y Acad Sci. 2017 Aug 10. doi: 10.1111/nyas.13429.

Lumbar Vertebral Endplate Defects on Magnetic Resonance Images: Classification, Distribution Patterns, and Associations with Modic Changes and Disc Degeneration.

Feng Z, Liu Y, Yang G, Battié MC, Wang Y. Spine (Phila Pa 1976). 2017 Oct 10. doi: 10.1097/BRS.0000000000002450.

Mechanisms of Failure Following Simulated Repetitive Lifting: A Clinically Relevant Biomechanical Cadaveric Study.

Amin DB, Tavakoli J, Freeman BJC, Costi JJ. Spine (Phila Pa 1976). 2018 Oct 7. doi: 10.1097/BRS.0000000000003270.

Modic changes—Their associations with low back pain and activity limitation: A systematic literature review and meta-analysis

Christofer Herlin, Per Kjaer, Ansgar Espeland, Jan Sture Skouen, Charlotte Leboeuf-Yde, Jaro Karppinen, Jaakko Niinimäki, Joan Solgaard Sørensen, Kjersti Storheim, Tue Secher Jensen. PLOS One. August 1, 2018. Doi: 10.1371/journal.pone.0200677

Molecular Mechanisms of Intervertebral Disc Degeneration.

Rider SM, Mizuno S, Kang JD. Spine Surg Relat Res. 2018 Apr 7;3(1):1-11. doi: 10.22603/ssrr.2017-0095.

New Evidence for Structural Integration across the Cartilage-Vertebral Endplate Junction and its Relation to Herniation

Nurul Haiza Sapiee, Ashvin Thambyah, Peter A. Robertson, Neil D. Broom. The Spine Journal. August 31, 2018. DOI: 10.1016/j.spinee.2018.08.013

Oswestry Disability Index scores correlate with MRI measurements in degenerating intervertebral discs and endplates.

Arpinar VE, Gliedt JA, King JA, Maiman DJ, Muftuler LT. Eur J Pain. 2019 Oct 8. doi: 10.1002/ejp.1490.

Piezoelectricity in the Intervertebral Disc

Philip Poillot, Joseph O’Donnell, David T. O’Connor, Ehtsham Ul Haq, … Jacques M. Huyghe. Journal of Biomechanics. 9 January 2020. DOI: 10.1016/j.jbiomech.2020.109622

Potential association of metabolic and musculoskeletal disorders with lumbar intervertebral disc degeneration: Cross-sectional study using medical checkup data.

Fujita N, Ishihara S, Michikawa T, Azuma K, Suzuki S, Tsuji O, Nagoshi N, Okada E, Yagi M, Tsuji T, Takayama M, Matsumoto H, Nakamura M, Matsumoto M, Watanabe K. J Orthop Sci. 2019 Jun 5. pii: S0949-2658(19)30146-0. doi: 10.1016/j.jos.2019.05.011.

Prevalence and Characteristics of Discogenic Pain in Tertiary Practice: 223 Consecutive Cases Utilizing Lumbar Discography.


Progression of lumbar disc herniations over an eight-year period in a group of adult Danes from the general population – a longitudinal MRI study using quantitative measures


Reality about migration of the nucleus pulposus within the intervertebral disc with changing postures.


Relationship between intervertebral disc and facet joint degeneration: A probabilistic finite element model study.

Bashkuev M, Reitmaier S, Schmidt H. J Biomech. 2019 Nov 16:109518. doi: 10.1016/j.jbiomech.2019.109518.

Serum levels of the pro-inflammatory interleukins 6 (IL-6) and -8 (IL-8) in patients with lumbar radicular pain due to disc herniation: A 12-month prospective study.

Pedersen LM, Schistad E, Jacobsen LM, Røe C, Gjerstad J. Brain Behav Immun. 2015 May;46:132-6. doi: 10.1016/j.bbi.2015.01.008.

Signal Intensity of Lumbar Disc Herniations: Correlation With Age of Herniation for Extrusion, Protrusion, and Sequestration

MARKUS RAFAEL KONIECZNY, JEREMIA REINHARDT, MAX PROST, CHRISTOPH SCHLEICH, RÜDIGER KRAUSPE. Int J Spine Surg. 2020 Feb; 14(1): 102–107. Published online 2020 Feb 29. doi: 10.14444/7014

Sitting versus standing: does the intradiscal pressure cause disc degeneration or low back pain?


Spinopelvic alignment predicts disc calcification, displacement, and Modic changes: Evidence of an evolutionary etiology for clinically-relevant spinal phenotypes.

Zehra U, Cheung JPY, Bow C, Crawford RJ, Luk KDK, Lu W, Samartzis D. JOR Spine. 2020 Feb 19;3(1):e1083. doi: 10.1002/jsp2.1083.

Temporal interactions of degenerative changes in individual components of the lumbar intervertebral discs: a sequential magnetic resonance imaging study in patients less than 40 years of age.


Tensile behaviour of individual fibre bundles in the human lumbar anulus fibrosus

Diana T. Pham, Joe G. Shapter, John J. Costi. Journal of Biomechanics. November 28, 2017. DOI:10.1016/j.jbiomech.2017.11.016

The association of combination of disc degeneration, end plate signal change, and Schmorl node with low back pain in a large population study: the Wakayama Spine Study.


The association of combination of disc degeneration, end plate signal change, and Schmorl node with low back pain in a large population study: the Wakayama Spine Study.


The cellular and molecular biology of the intervertebral disc: A clinician’s primer


The contribution of facet joints, axial compression, and composition to human lumbar disc torsion mechanics.

Bezci SE, Eleswarapu A, Klineberg EO, O’Connell GD. J Orthop Res. 2018 Feb 12. doi: 10.1002/jor.23870.

The nerve supply of the lumbar intervertebral disc


The prevalence of depression in axial spondyloarthritis and its association with disease activity: a systematic review and meta-analysis.

Zhao S, Thong D, Miller N, Duffield SJ, Hughes DM, Chadwick L, Goodson NJ. Arthritis Res Ther. 2018 Jul 11;20(1):140. doi: 10.1186/s13075-018-1644-6.

The probability of spontaneous regression of lumbar herniated disc: a systematic review.


The Relationship between Disc Degeneration and Morphologic Changes in the Intervertebral Foramen of the Cervical Spine: A Cadaveric MRI and CT Study


The Relationship Between Low-Grade Infection and Degenerative Disk Disease: A Review of Basic Science and Clinical Data.

Iyer S, Louie PK, Nolte MT, Phillips FM. J Am Acad Orthop Surg. 2018 Dec 17. doi: 10.5435/JAAOS-D-18-00257.

The Role of Type I Diabetes in Intervertebral Disc Degeneration.

Russo F, Ambrosio L, Ngo K, Vadalà G, Denaro V, Fan Y, Sowa G, Kang JD, Vo N. Spine (Phila Pa 1976). 2019 Apr 8. doi: 10.1097/BRS.0000000000003054.

The value of radiographic indexes in the diagnosis of discogenic low back pain: a retrospective analysis of imaging results.

Song J, Wang HL, Ma XS, Xia XL, Lu FZ, Zheng CJ, Jiang JY. Oncotarget. 2017 Jun 27;8(36):60558-60567. doi: 10.18632/oncotarget.

Three-dimensional analysis of volumetric changes in herniated discs of the lumbar spine: does spontaneous resorption of herniated discs always occur?

Seo JY, Roh YH, Kim YH, Ha KY. Eur Spine J. 2016 May

Uneven intervertebral motion sharing is related to disc degeneration and is greater in patients with chronic, non-specific low back pain: an in vivo, cross-sectional cohort comparison of intervertebral dynamics using quantitative fluoroscopy.

Breen A, Breen A. Eur Spine J. 2017 May 29. doi: 10.1007/s00586-017-5155-y.

Vertebral Endplate Defect as Initiating Factor in Intervertebral Disc Degeneration; Strong Association between Endplate Defect and Disc Degeneration in the General Population.

Rade M, Määttä JH, Freidin MB, Airaksinen O, Karppinen J, Williams FM. Spine (Phila Pa 1976). 2017 Jul 26. doi: 10.1097/BRS.0000000000002352.

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