Abstract
Lower back pain is a medical condition of epidemic proportion, and the degeneration of the intervertebral disc has been identified as a major contributor. The etiology of intervertebral disc (IVD) degeneration is multifactorial, depending on age, cell-mediated molecular degradation processes and genetics, which is accelerated by traumatic or gradual mechanical factors. The complexity of such intertwined biochemical and mechanical processes leading to degeneration makes it difficult to quantitatively identify cause–effect relationships through experiments. Computational modeling of the IVD is a powerful investigative tool since it offers the opportunity to vary, observe and isolate the effects of a wide range of phenomena involved in the degenerative process of discs. This review aims at discussing the main findings of finite element models of IVD pathophysiology with a special focus on the different factors contributing to physical changes typical of degenerative phenomena. Models presented are subdivided into those addressing role of nutritional supply, progressive biochemical alterations stemming from an imbalance between anabolic and catabolic processes, aging and those considering mechanical factors as the primary source that induces morphological change within the disc. Limitations of the current models, as well as opportunities for future computational modeling work are also discussed.
Highlights
Lower back pain is a medical condition of epidemic proportion, costing over $100 billion annually in both direct and indirect expenditures in the United States alone
The process of intervertebral disc (IVD) degeneration occurs as a perturbation of the homeostatic balance between synthesis and degradation of its extracellular matrix (ECM) components: cell catabolic activity exceeds anabolism
This review aims to discuss the main findings of computational models of IVD pathophysiology with a special focus on the different factors contributing to physical changes typical of degenerative phenomena
Summary
Lower back pain is a medical condition of epidemic proportion, costing over $100 billion annually in both direct and indirect expenditures in the United States alone. Computational modeling is a powerful tool to study complex biological systems which is garnering more and more popularity in the scientific community This methodological approach has been adopted to investigate IVD degenerative changes. The models studied are subdivided in the following groups: (1) those investigating the role of nutrient supply on the viability and metabolism of disc cells; (2) those addressing progressive biochemical alterations stemming from an imbalance between anabolic and catabolic processes; (3). Those addressing the natural process of aging as a contributor to IVD degradation; and (4) those considering mechanical factors as the primary source that induces morphological change within the disc. Discussion on genetic predisposition on the onset and progress of disc degeneration are excluded from this review
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
