1.1 Lower Back Pain due to IVD degeneration
Lower Back Pain(LBP) is broadly recognised as the single leading cause of disability in the world. It affects about 60-80% of the adult population and is a socioeconomic burden in the developed society today (Krock et al.2015). In the UK, approximately £12 billion is spent in the treatment of LBP, lost work days and social benefits (Maniadakis and Gray, 2000). A worse detrimental economic loss can be observed in the USA almost totalling $85 billion (Ludwinski et al., 2013). To date, the pathogenesis of back pain has not been fully understood. Lower back pain is believed to have several causes for example obesity, occupation and heredity, however, 40% of all cases are known to be caused by IVD degeneration (Clarke et al. 2014).
1.2 IVD structure and Function
The major role of the IVD is to enable movement of vertebral bodies and provide stability to the spine (Humzah and Soames, 1988). The 24 vertebrae of the spinal cord are separated by IVD to also prevent the vertebrae from rubbing against each other, in addition, …show more content…
Wuertz et al. (2014) discovered that low nutrients and hypoxia on rat BM-MSCs induces ACAN and COL1 expression and increased proliferation. However, hypoxia leads to the production of lactic acid which results in an acidic pH in the disc. Both hypoxia and high osmolarity typical of the degenerate NP environment were shown to affect discogenic differentiation negatively by decreasing ECM matrix expression and proliferation (Oh et al. 2010). When all three conditions; low nutrients, low pH, and high osmolarity were combined, the same detrimental effect was still observed, therefore showing that pH and osmolarity have a greater effect on the survival of MSCs than low nutrient supply. As these conditions impede the growth, this suggests that priming might indeed be essential for stem cell
Lower Back Pain(LBP) is broadly recognised as the single leading cause of disability in the world. It affects about 60-80% of the adult population and is a socioeconomic burden in the developed society today (Krock et al.2015). In the UK, approximately £12 billion is spent in the treatment of LBP, lost work days and social benefits (Maniadakis and Gray, 2000). A worse detrimental economic loss can be observed in the USA almost totalling $85 billion (Ludwinski et al., 2013). To date, the pathogenesis of back pain has not been fully understood. Lower back pain is believed to have several causes for example obesity, occupation and heredity, however, 40% of all cases are known to be caused by IVD degeneration (Clarke et al. 2014).
1.2 IVD structure and Function
The major role of the IVD is to enable movement of vertebral bodies and provide stability to the spine (Humzah and Soames, 1988). The 24 vertebrae of the spinal cord are separated by IVD to also prevent the vertebrae from rubbing against each other, in addition, …show more content…
Wuertz et al. (2014) discovered that low nutrients and hypoxia on rat BM-MSCs induces ACAN and COL1 expression and increased proliferation. However, hypoxia leads to the production of lactic acid which results in an acidic pH in the disc. Both hypoxia and high osmolarity typical of the degenerate NP environment were shown to affect discogenic differentiation negatively by decreasing ECM matrix expression and proliferation (Oh et al. 2010). When all three conditions; low nutrients, low pH, and high osmolarity were combined, the same detrimental effect was still observed, therefore showing that pH and osmolarity have a greater effect on the survival of MSCs than low nutrient supply. As these conditions impede the growth, this suggests that priming might indeed be essential for stem cell