What is Intervertebral Disc Degeneration, and What Causes It?

Michael A. Adams, PhD; Peter J. Roughley, PhD

Disclosures

Spine. 2006;31(18):2151-2161. 

In This Article

Disc Degeneration: Epidemiology

Regardless of which definition is used, disc degeneration increases with age and is most common in the lower lumbar spine.[65] The highest risk factor is genetic inheritance, which accounts for approximately 50-70% of the variability in disc degeneration between identical twins.[1m90] It is noteworthy that this 50-70% does not include the strong intrasubject dependence of disc degeneration on spinal level, which probably reflects environmental influences.[1] Individual genes associated with disc degeneration include those for collagen type IX,[91] aggrecan,[92] vitamin D receptor,[93] MMP3,[94] and cartilage intermediate layer protein.[95] The products of these genes probably affect the strength of skeletal tissues, and their systemic effects may explain why disc degeneration is more prevalent in those with osteoarthritis.[74] Environmental risk factors for disc degeneration include high and repetitive mechanical loading1,[96] and smoking cigarettes.[97] Disc prolapse is closely associated with heavy lifting,[98] but not with other features of spinal degeneration or age,[65] suggesting that prolapse is not an integral part of the aging process.

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