退行性椎间盘病变的病因及病理机制
吴宗优
王楷雄
孔清泉
610041 成都,四川大学华西医院骨科
摘要：Low back pain(LBP),defined as the pain localized between the 12th thoracic rib and the gluteal sulcus,has shown a rising global prevalence,affecting approximately 600 million individuals in 2024,with nonspecific LBP being the most common presentation.Current evidence identifies intervertebral disc degeneration(IVDD)as a primary contributor to nonspecific LBP.IVDD rises from extrinsic factors(acute trauma,repetitive mechanical stress)and intrinsic factors(aging,genetic predisposition,metabolic dysregulation),which triggers inflammatory cascades,extracellular matrix(ECM)degradation(notably proteoglycans and type Ⅱ collagen),disc dehydration,and mechanical instability.Abnormal innervation,particularly via sinuvertebral nerve ingrowth,further exacerbates chronic pain.Traditional therapies and primarily analgesics alleviate symptoms but fail to halt IVDD progression.Recent advances highlight the roles of inflammation,cellular senescence,oxidative stress,metabolic dysfunction,and autonomic sensitization in IVDD pathogenesis.Emerging interventions,such as senolytics,M2 macrophage polarization,and targeted anti-inflammatory therapies,offer potential to modify IVDD progression.This review synthesizes IVDD etiology,molecular mechanisms,and novel therapeutic strategies,providing a foundation for future research aimed at reversing or halting disc degeneration.
关键词：椎间盘退行性变腰痛炎症氧化性应激细胞衰老
分类号：R681.5(骨科学（运动系疾病、矫形外科学）)
论文发表日期：2025-07-19
在线出版日期：2025-08-15（本平台首次上网日期，不代表文献的发表时间）
页数：7( 577-583 )
英文信息