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Mechanobiology of the Human Intervertebral Disc: Systematic Review of the Literature and Future Perspectives

PainSci » bibliography » Ruffilli et al 2023
Tags: spine, back pain, exercise, pain problems, self-treatment, treatment

PainSci commentary on Ruffilli 2023: ?This page is one of thousands in the bibliography. It is not a general article: it is focused on a single scientific paper, and it may provide only just enough context for the summary to make sense. Links to other papers and more general information are provided wherever possible.

This is a comprehensive review of how human intervertebral discs respond to mechanical stimuli, with the main takeaway being that they do respond — but it’s complicated, and we still have a lot to learn.

Despite the profusion of back pain and spinal research in general, this review reports on surprisingly little useful research to date, just 15 papers since 1990 that met their standards — one every couple years.

Despite our persistent ignorance on this important topic, it’s probably mostly safe to assume that mechanical loading affects discs in the same general way it affects most tissues: it does best with a “just right” amount of stimulation, and gets into trouble with too much or too little. For instance, “moderate mechanical loading may be important in preventing disc matrix degradation” and therefore “moderate exercise may be have a protective role against disc degeneration.” But for a disc that’s already degenerating? That “may have detrimental consequences, although this requires further research.”

~ Paul Ingraham

original abstract Abstracts here may not perfectly match originals, for a variety of technical and practical reasons. Some abstacts are truncated for my purposes here, if they are particularly long-winded and unhelpful. I occasionally add clarifying notes. And I make some minor corrections.

Low back pain is an extremely common condition with severe consequences. Among its potential specific causes, degenerative disc disease (DDD) is one of the most frequently observed. Mechanobiology is an emerging science studying the interplay between mechanical stimuli and the biological behavior of cells and tissues. The aim of the presented study is to review, with a systematic approach, the existing literature regarding the mechanobiology of the human intervertebral disc (IVD), define the main pathways involved in DDD and identify novel potential therapeutic targets. The review was carried out in accordance with the Preferential Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. Studies were included if they described biological responses of human IVD cells under mechanical stimulation or alterations of mechanical properties of the IVD determined by different gene expression. Fifteen studies were included and showed promising results confirming the mechanobiology of the human IVD as a key element in DDD. The technical advances of the last decade have allowed us to increase our understanding of this topic, enabling us to identify possible therapeutic targets to treat and to prevent DDD. Further research and technological innovations will shed light on the interactions between the mechanics and biology of the human IVD.

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This page is part of the PainScience BIBLIOGRAPHY, which contains plain language summaries of thousands of scientific papers & others sources. It’s like a highly specialized blog. A few highlights:

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