Intervertebral disc homeostasis at normal conditions and during pathology

Abstract

Intervertebral discs are rather complex structural units of the spine. It is believed that a disturbance of the factors of their homeostasis immediately leads to changes in the bone tissue of the vertebral bodies and, consequently, to pathological changes at the level of the vertebral-motor segment. It follows that the maintenance of normal metabolism within the discs is one of the key directions in the prevention of many clinically important lesions involving the entire vertebral complex. The causes of metabolic processes disorders in the intervertebral disc can be divided into several levels: chronic diseases that directly affect the blood supply to the spinal column as a whole; diseases that affect the permeability of the capillary zone of the subchondral zone of the vertebral bodies; disturbances in the delivery of nutrients into the disc through its matrix, which serves an important selective barrier. However, regardless of the level of the causes of metabolic disorders, all of which eventually lead to anatomical and functional changes in the intervertebral discs and to their subsequent incapacity to provide the daily life cycle of the vertebral complex, consisting of periods of stress and relaxation. Thus, based on the known literature data we can conclude that: the intervertebral discs to date, remain poorly understood elements, however even from a narrow range of studies on this subject it is evident that their functionality is largely dependent on the properties of the disc matrix and the interstitial nature of metabolic processes.