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Intervertebral disc

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An intervertebral disc is a specialized structure located between adjacent vertebrae in the vertebral column. These discs function as fibrocartilaginous joints, which are joints that allow for slight movement between bones. They serve several vital roles: they act as ligaments to hold the vertebrae together, they provide a surface for movement, and they function as shock absorbers for the spine.

Cervical vertebra english
Cervical vertebra english

By absorbing impact, they protect the vertebral column during physical activity. Without these discs, the bones of the spine would lack the necessary cushioning to handle the stresses of daily life.

The structure of the disc consists of two main parts: the anulus fibrosus and the nucleus pulposus. The anulus fibrosus is an outer fibrous ring made of several layers, or laminae, of fibrocartilage. This ring contains both type I and type II collagen. Type I collagen is concentrated toward the outer edge to provide extra strength. These stiff laminae are designed to withstand heavy compressive forces.

Degenerative disc disease - high mag
Degenerative disc disease - high mag

Inside this ring lies the nucleus pulposus, which is a gel-like center. This center contains loose fibers suspended in a mucoprotein gel. It is actually a remnant of the notochord, a structure from early development.

The mechanism of the disc relies on hydraulic pressure to protect the spine. When the body experiences compressive loads, the nucleus pulposus distributes that pressure evenly in all directions. This process prevents stress concentrations that could damage the vertebrae or their endplates. The gel center is composed of large vacuolated notochord cells, small chondrocyte-like cells, and collagen fibrils. It also contains aggrecan, which is a proteoglycan that binds to hyaluronan.

Disc Herniation
Disc Herniation

Aggrecan molecules have glycosaminoglycan (GAG) chains, such as chondroitin sulfate and keratan sulfate, attached to them. Because these aggrecan molecules are negatively charged, they increase oncotic pressure. This causes extracellular fluid to shift from the outside into the nucleus pulposus, keeping the disc hydrated.

Humans have 23 intervertebral discs distributed throughout the spine. There are 6 discs in the cervical region of the neck. The thoracic region, or the middle back, contains 12 discs. The lumbar region, located in the lower back, has 5 discs.

3D Medical Animation scoliosis Intervertibral Disc
3D Medical Animation scoliosis Intervertibral Disc

There is a disc between every pair of vertebrae, with one exception. The first cervical segment, called the atlas, is a ring around the axis. The axis is the second cervical segment and acts as a post. This allows the atlas to rotate so the neck can swivel.

Discs are identified by the vertebral bodies they sit between. For instance, the disc between the fifth and sixth cervical vertebrae is labeled "C5-6." While discs have a vascular supply to the cartilage endplates and the anulus fibrosus during development, this supply deteriorates quickly. In healthy adults, the discs have almost no direct blood supply. Doctors often use X-ray photographs to define the intervertebral disc space, which is the space between adjacent vertebrae. In healthy patients, this space matches the actual size of the disc.

Changes in the disc can lead to clinical issues, often termed discogenic when they cause pain. A herniated disc, or "slipped disc," occurs when unbalanced mechanical pressures deform the anulus fibrosus. This allows part of the nucleus pulposus to obtrude or bulge outward. This can happen due to trauma, peak physical performance, or chronic deterioration from poor posture.

Disc Herniation
Disc Herniation

When the material is forced laterally or posteriorly, it can press on nearby nerves. This may cause symptoms like numbness, paresthesia, or loss of muscle tone. Another type is vertical disc herniation, which involves the formation of Schmorl's nodes.

Degeneration is a normal part of aging, but it can change the disc's function. As people age, the nucleus pulposus dehydrates and the concentration of proteoglycans decreases. This limits the disc's ability to absorb shock and can lead to a decrease in overall human height. Approximately 25% of people under age 40 show evidence of degeneration. Beyond age 40, more than 60% of people show these changes on an MRI. Other spinal conditions like scoliosis, which is an S-shaped curvature, can also affect disc morphology by causing calcium deposits in the cartilage endplate.

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File:Cervical vertebra english.png
Cervical vertebra english.png
File:Disc Herniation.JPG
Disc Herniation.JPG
File:Degenerative disc disease - high mag.jpg
Degenerative disc disease - high mag.jpg
File:3D Medical Animation scoliosis Intervertibral Disc.jpg
3D Medical Animation scoliosis...
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