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413:, which provides cushioning and flexibility for the spine. Much of the mechanical stress that is caused by everyday movements is transferred to the discs within the spine and the water content within them allows them to effectively absorb the shock. At birth, a typical human nucleus pulposus will contain about 80% water. However natural daily stresses and minor injuries can cause these discs to gradually lose water as the
25:
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techniques involved in open discectomy is known as
Subtotal Discectomy (SD; or, aggressive discectomy) and the latter, Limited Discectomy (LD; or, conservative discectomy). However, with either technique, the probability of post-operative reherniation exists and at a considerably high maximum of 21%, prompting patients to potentially undergo recurrent disk surgery.
1220:
Jaspaul S.; Gokaslan, Ziya L.; Kuo, Calvin C.; Lee, Yu-Po; Mavrommatis, Konstantinos; Michu, Elleni; Noskova, Hana; Raz, Assaf; Sana, Jiri; Shamie, A. Nick; Stewart, Philip S.; Stonemetz, Jerry L.; Wang, Jeffrey C.; Witham, Timothy F.; Coscia, Michael F.; Birkenmaier, Christof; Fischetti, Vincent A.; Slaby, Ondrej (3 April 2017).
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include introduction of biologically engineered, injectable riboflavin cross-linked high density collagen (HDC-laden) gels into disease spinal segments to induce regeneration, ultimately restoring functionality and structure to the two main inner and outer components of vertebral discs—anulus fibrosus and the nucleus pulposus.
424:. As the space between vertebrae gets smaller, extra pressure can be placed on the discs causing tiny cracks or tears to appear in the annulus. If enough pressure is exerted, it is possible for the nucleus pulposus material to seep out through the tears in the annulus and can cause what is known as a
546:
Fibrocartilage replaces the gelatinous mucoid material of the nucleus pulposus as the disc changes with age. There may be splits in the anulus fibrosus, permitting herniation of elements of nucleus pulposus. There may also be shrinkage of the nucleus pulposus that produces prolapse or folding of the
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is made incidentally when a cervical x-ray, chest x-ray, or abdominal x-ray is taken for other reasons, and the abnormalities of the vertebral column are recognized. The diagnosis of DDD is not a radiologic diagnosis, since the interpreting radiologist is not aware whether there are symptoms present
1219:
Capoor, Manu N.; Ruzicka, Filip; Schmitz, Jonathan E.; James, Garth A.; Machackova, Tana; Jancalek, Radim; Smrcka, Martin; Lipina, Radim; Ahmed, Fahad S.; Alamin, Todd F.; Anand, Neel; Baird, John C.; Bhatia, Nitin; Demir-Deviren, Sibel; Eastlack, Robert K.; Fisher, Steve; Garfin, Steven R.; Gogia,
348:
Degenerative disc disease can result in lower back or upper neck pain. The amount of degeneration does not correlate well with the amount of pain patients experience. Many people experience no pain while others, with the same amount of damage have severe, chronic pain. Whether a patient experiences
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Traditional approaches in treating patients with DDD-resultant herniated discs oftentimes include discectomy—which, in essence, is a spine-related surgical procedure involving the removal of damaged intervertebral discs (either whole removal, or partially-based). The former of these two discectomy
659:
Dynamic
Stabilisation: Following a discectomy, a stabilisation implant is implanted with a 'dynamic' component. This can be with the use of Pedicle screws (such as Dynesys or a flexible rod) or an interspinous spacer with bands (such as a Wallis ligament). These devices off load pressure from the
352:
Degenerative disc disease is one of the most common sources of back pain and affects approximately 30 million people every year. With symptomatic degenerative disc disease, the pain can vary depending on the location of the affected disc. A degenerated disc in the lower back can result in lower
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Researchers and surgeons have conducted clinical and basic science studies to uncover the regenerative capacity possessed by the large animal species involved (humans and quadrupeds) for potential therapies to treat the disease. Some therapies, carried out by research laboratories in New York,
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or cell transplantation therapies for disc regeneration are in their infancy of development, but initial clinical trials have shown cell transplantation to be safe and initial observations suggest some beneficial effects for associated pain and disability. An optimal cell type, transplantation
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and fusion: A procedure that reaches the cervical spine (neck) through a small incision in the front of the neck. The intervertebral disc is removed and replaced with a small plug of bone or other graft substitute, along with a height restoration device to un-impinge nerves, and in time, the
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Surgery may be recommended if the conservative treatment options do not provide relief within two to three months for cervical or 6 months for lumbar symptoms. If leg or back pain limits normal activity, if there is weakness or numbness in the legs, if it is difficult to walk or stand, or if
384:
A degenerated disc in the upper neck will often result in pain to the neck, arm, shoulders and hands; tingling in the fingers may also result if nerve impingement is occurring. Pain is most commonly felt or worsened by movements such as sitting, bending, lifting, and twisting.
442:
around the disc space in an attempt to stop excess motion. This can cause issues if the bone spurs start to grow into the spinal canal and put pressure on the spinal cord and surrounding nerve roots as it can cause pain and affect nerve function. This condition is called
1597:
340:, ice and heat. Immediate surgery may be indicated if the symptoms are severe or sudden in onset, or there is a sudden worsening of symptoms. Elective surgery may be indicated after six months of conservative therapy with unsatisfactory relief of symptoms.
417:, or the tough outer fibrous material of a disc, weakens. Because degenerative disc disease is largely due to natural daily stresses, the American Academy of Orthopaedic Manual Physical Therapists have suggested it is not truly a "disease" process.
1110:
Anjankar SD, Poornima S, Raju S, Jaleel M, Bhiladvala D, Hasan Q. Degenerated intervertebral disc prolapse and its association of collagen I alpha 1 Spl gene polymorphism: A preliminary case control study of Indian population. Indian J Orthop
458:-loss are associated with lumbar disc degeneration, usually occurring during the first 15 years of the climacteric. The potential role of sex hormones in the etiology of degenerative skeletal disorders is being discussed for both genders.
400:
material. Degenerative disc disease can lead to a chronic debilitating condition and can reduce a person's quality of life. When pain from degenerative disc disease is severe, traditional nonoperative treatment may be ineffective.
1067:
Lou, C.; Chen, H-L.; Feng, X-Z.; Xiang, G-H.; Zhu, S-P.; Tian, N-F.; Jin, Y-L.; Fang, M-Q.; Wang, C.; Xu, H-Z. (December 2014). "Menopause is associated with lumbar disc degeneration: a review of 4230 intervertebral discs".
1664:
Pennicooke, Brenton; Hussain, Ibrahim; Berlin, Connor; Sloan, Stephen R.; Borde, Brandon; Moriguchi, Yu; Lang, Gernot; Navarro-Ramirez, Rodrigo; Cheetham, Jonathan; Bonassar, Lawrence J.; Härtl, Roger (February 2018).
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therapy knife-less fusion of vertebrae in the United States began in 2006 and a DiscGenics nucleus pulposus progenitor cell transplantation clinical trial has started as of 2018 in the United States and Japan.
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or not. Typical radiographic findings include disc space narrowing, displacement of vertebral bodies, fusion of adjacent vertebral bodies, and development of bone in adjacent soft tissue (
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disc by rerouting pressure through the posterior part of the spinal column. Like a fusion, these implants allow and maintain mobility to the segment by allowing flexion and extension.
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is involved. Diagnosis is suspected when typical symptoms and physical findings are present; and confirmed by x-rays of the vertebral column. Occasionally the radiologic diagnosis of
567:
Diagnosis of degenerative disc disease will usually consist of an analysis of a patient's individual medical history and an MRI to confirm the diagnosis and rule out other causes.
1598:"DiscGenics Receives Approval from Japanese Pharmaceuticals and Medical Devices Agency to Begin Clinical Evaluation of Non-Surgical Degenerative Disc Disease Treatment in Japan"
603:. There are many surgical options for the treatment of degenerative disc disease, including anterior and posterior approaches. The most common surgical treatments include:
705:
Percutaneous disc decompression: A procedure that reduces or eliminates a small portion of the bulging disc through a needle inserted into the disc, minimally invasive.
652:: A procedure that removes a portion of the vertebra and adjacent intervertebral discs to allow for decompression of the cervical spinal cord and spinal nerves. A
388:
After an injury, some discs become painful because of inflammation and the pain comes and goes. Some people have nerve endings that penetrate more deeply into the
686:(IDET): A procedure wherein the disc is heated to 90 °C for 15 minutes in an effort to seal the disc and perhaps deaden nerves irritated by the degeneration.
349:
pain or not largely depends on the location of the affected disc and the amount of pressure that is being put on the spinal column and surrounding nerve roots.
215:, which in turn causes loss of fluid volume. Normal downward forces cause the affected disc to lose height, and the distance between vertebrae is reduced. The
392:(outer layer of the disc) than others, making discs more likely to generate pain. The healing of trauma to the outer anulus fibrosus may also result in the
726:
by relieving pressure on the spinal cord. A part of the lamina is removed or trimmed to widen the spinal canal and create more space for the spinal nerves.
409:
There is a disc between each of the vertebrae in the spine. A healthy, well-hydrated disc will contain a great deal of water in its center, known as the
692:: A procedure that reaches the cervical spine from the back of the neck. The spinal canal is then reconstructed to make more room for the spinal cord.
547:
anulus fibrosus with secondary osteophyte formation at the margins of the adjacent vertebral body. The pathologic findings in DDD include protrusion,
504:– that encode for proteins and enzymes involved in the regulation of the extracellular matrix has been shown to contribute to lumbar disc herniation.
199:) is a medical condition typically brought on by the aging process in which there are anatomic changes and possibly a loss of function of one or more
35:
207:. DDD can take place with or without symptoms, but is typically identified once symptoms arise. The root cause is thought to be loss of soluble
803:
Fardon, David F.; Williams, Alan L.; Dohring, Edward J.; Murtagh, F. Reed; Gabriel
Rothman, Stephen L.; Sze, Gordon K. (November 2014).
96:
2408:
68:
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1849:
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Farshad-Amacker, Nadja A.; Farshad, Mazda; Winklehner, Anna; Andreisek, Gustav (2015). "MR imaging of degenerative disc disease".
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75:
1172:"A Functional Polymorphism in THBS2 that Affects Alternative Splicing and MMP Binding Is Associated with Lumbar-Disc Herniation"
2948:
1615:
Moriguchi, Yu; Alimi, Marjan; Khair, Thamina; Manolarakis, George; Berlin, Connor; Bonassar, Lawrence J.; Härtl, Roger (2016).
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Degenerative disc disease can occur in other mammals besides humans. It is a common problem in several dog breeds, such as the
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with emphasis on correcting abnormal posture, assisting the paravertebral (paraspinous) muscles in stabilizing the spine, and
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1617:"Biological Treatment Approaches for Degenerative Disk Disease: A Literature Review of In Vivo Animal and Clinical Data"
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Mutations in several genes have been implicated in intervertebral disc degeneration. Probable candidate genes include
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formation). An MRI is typically reserved for those with symptoms, signs, and x-ray findings suggesting the need for
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is removed by way of a surgical instrument or laser while using an operating microscope or loupe for magnification.
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This water loss makes the discs more flexible and results in the gradual collapse and narrowing of the gap in the
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1842:
1222:"Propionibacterium acnes biofilm is present in intervertebral discs of patients undergoing microdiscectomy"
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injections may offer pain relief for some without precluding the use of more aggressive treatment options.
699:
765:, and attempts to remove this disease from dog populations have led to several hybrid breeds, such as the
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method, cell density, carrier, or patient indication remains to be determined. Investigation into
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1456:"Cell therapy for intervertebral disc herniation and degenerative disc disease: clinical trials"
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to increase the size of the nerve pathway. This surgery can be done alone or with a laminotomy.
633:: also called Artificial Disc Replacement (ADR), or Total Disc Replacement (TDR), is a type of
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As the two vertebrae above and below the affected disc begin to collapse upon each other, the
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and clusters of chondrocytes, suggestive of repair. Inflammation may or may not be present.
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373:, or legs. If pressure is being placed on the nerves by exposed nucleus pulposus, sporadic
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219:, the tough outer layers of a disc, also weakens. This loss of height causes laxity of the
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Emerson AJ, Naze G, Mabry LM, Chaconas E, Silvernail J, Lonnemann E, Rhon D, Deyle GD.
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of the scar tissue and pain impulses from the disc, as these nerves become inflamed by
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medication or physical therapy are ineffective, surgery may be necessary, most often
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anteriorly (to the left) on the lower portion of the C5 and upper portion of the C6
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Degenerated disc between C5 and C6 (vertebra at the top of the picture is C2), with
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New treatments are emerging that are still in the beginning clinical trial phases.
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American
Academy of Orthopaedic Manual Physical Therapists Member's Resources Page
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are replaced with artificial ones in the lumbar (lower) or cervical (upper) spine.
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Additionally, the body can react to the closing gap between vertebrae by creating
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1667:"Annulus Fibrosus Repair Using High-Density Collagen Gel: An In Vivo Ovine Model"
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examination of disc fragments resected for presumed DDD is routine to exclude
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of a fragment of a resected degenerative vertebral disc, showing degenerative
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at the back of the spine are forced to shift which can affect their function.
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1989:
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656:, and in some cases a metal plate and screws, is used to stabilize the spine.
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899:"Degenerative Disc Disease Treatment|Degeneratice Disc Disease Treatments"
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Lee, Yu Chao; Zotti, Mario
Giuseppe Tedesco; Osti, Orso Lorenzo (2016).
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Often, the symptoms of degenerative disc disease can be treated without
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711:: A non-invasive procedure that temporarily (a few hours) enlarges the
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623:
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within the fluid contained in the disc with resultant reduction of the
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if you can. Unsourced or poorly sourced material may be challenged and
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1123:"Genetic background of degenerative disc disease in the lumbar spine"
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1338:"Anterior Cervical Spine Surgery for Degenerative Disease: A Review"
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1505:"Cell therapy for intervertebral disc repair: Clinical perspective"
474:
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366:
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922:
Kasbia, Virinder (8 September 2005). "Degenerative disc disease".
223:, which may allow anterior, posterior, or lateral shifting of the
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288:, either acute or chronic, near the involved disc, as well as
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971:"AAOMPT Opposes Use of the Term "Degenerative Disc Disease""
802:
140:
Degenerative disc disorder, intervertebral disc degeneration
2104:
497:
482:
362:
285:
996:"Operative Management of Lumbar Degenerative Disc Disease"
1218:
358:
1557:. Australian Life Scientist. 2006-11-27. Archived from
715:(IVF) by aiding in the rehydration of the spinal discs.
698:: A procedure that removes only a small portion of the
551:, and subluxation of vertebrae (spondylolisthesis) and
1739:
1407:"Risk factors for recurrent lumbar disc herniations"
1386:"Degenerative Disc Disease – When Surgery Is Needed"
968:
16:
Loss of function in the spine's intervertebral discs
1323:"How Fast Does Degenerative Disc Disease Progress?"
595:can provide adequate relief of troubling symptoms.
637:. It is a surgical procedure in which degenerated
2935:
1066:
531:Degenerative discs typically show degenerative
49:Please review the contents of the article and
2120:
1843:
579:. One or a combination of treatments such as
316:for pain relief, ROM, and appropriate muscle/
277:and impingement of a spinal nerve, causing a
265:); or narrowing of the space through which a
993:
324:muscle strengthening; stretching exercises;
1503:Sakai, Daisuke; Schol, Jordy (April 2017).
1454:Schol, Jordy; Sakai, Daisuke (April 2019).
615:surgical procedure in which a portion of a
257:; narrowing of the space available for the
2409:Reproductive endocrinology and infertility
2127:
2113:
1850:
1836:
1502:
1453:
1170:Hirose, Yuichiro; et al. (May 2008).
1104:
145:
2750:Bachelor of Medicine, Bachelor of Surgery
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1471:
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666:: A procedure that removes a part of the
1335:
583:, anti-inflammatory medications such as
511:
805:"Lumbar Disc Nomenclature: Version 2.0"
702:to relieve pressure on the nerve roots.
2936:
1715:"Chiweenie - Dogs 101 | Animal Planet"
1169:
921:
381:through the knees and legs can occur.
334:non-steroidal anti-inflammatory agents
2108:
1831:
950:University of Maryland Medical Center
343:
336:(NSAIDS); and topical analgesia with
2888:
2649:Physical medicine and rehabilitation
1404:
851:
585:nonsteroidal anti-inflammatory drugs
18:
2898:
1555:"Mesoblast files spinal fusion IND"
13:
2785:Medical Scientist Training Program
1857:
1509:Journal of Orthopaedic Translation
1176:American Journal of Human Genetics
1127:Spine Surgery and Related Research
450:For women, there is evidence that
14:
2960:
1735:
1044:"Bone spurs Causes – Mayo Clinic"
891:
2917:
2907:
2897:
2887:
2878:
2877:
756:
684:Intervertebral disc annuloplasty
676:: A procedure that enlarges the
631:Intervertebral disc arthroplasty
555:. It has been hypothesized that
115:
23:
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1707:
1657:
1608:
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1572:
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1447:
1398:
1378:
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1315:
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903:www.instituteforchronicpain.org
2775:Doctor of Osteopathic Medicine
2209:Oral and maxillofacial surgery
1060:
1036:
987:
962:
938:
915:
845:
796:
523:and clusters of chondrocytes.
496:. Mutation in genes – such as
51:add the appropriate references
1:
2949:Bones of the vertebral column
1287:(9). Elsevier BV: 1768–1776.
1281:European Journal of Radiology
789:
627:vertebrae will fuse together.
507:
357:, sometimes radiating to the
284:DDD can cause mild to severe
2755:Bachelor of Medical Sciences
2522:Neurosurgical anesthesiology
2134:
2071:Intervertebral disc disorder
1683:10.1097/BRS.0000000000002334
1342:Neurologia Medico-Chirurgica
1247:10.1371/journal.pone.0174518
1082:10.3109/13697137.2014.933409
822:10.1097/BRS.0b013e3182a8866d
570:
562:
7:
1293:10.1016/j.ejrad.2015.04.002
946:"Degenerative Disc Disease"
870:10.1016/j.ejrad.2015.01.018
772:
722:: A procedure for treating
65:"Degenerative disc disease"
36:reliable medical references
10:
2965:
1460:International Orthopaedics
1188:10.1016/j.ajhg.2008.03.013
617:herniated nucleus pulposus
593:epidural steroid injection
2873:
2795:
2733:
2494:
2422:
2377:
2286:
2157:
2142:
2084:Degenerative disc disease
2069:
2024:
1977:
1934:
1925:
1900:
1872:
1865:
1743:
1522:10.1016/j.jot.2017.02.002
1473:10.1007/s00264-018-4223-1
1405:Shin, Byung-Joon (2014).
1012:10.4184/asj.2016.10.4.801
273:stenosis) with resultant
193:Degenerative disc disease
185:Connective tissue disease
178:
166:
153:
144:
136:
132:Degenerative disc disease
131:
42:or relies too heavily on
2709:Transplantation medicine
2600:Clinical neurophysiology
2517:Obstetric anesthesiology
2437:Interventional radiology
2197:Digestive system surgery
1423:10.4184/asj.2014.8.2.211
1354:10.2176/nmc.ra.2014-0403
404:
2580:Intensive care medicine
2554:Mass gathering medicine
2399:Maternal–fetal medicine
1336:Sugawara, Taku (2015).
1139:10.22603/ssrr.2017-0007
2944:Chronic pain syndromes
2172:Cardiothoracic surgery
2089:Spinal disc herniation
1947:Ankylosing spondylitis
1633:10.1055/s-0036-1571955
1121:Kawaguchi, Y. (2018).
713:intervertebral foramen
670:to increase the space.
528:
312:Treatment may include
292:if an adjacent spinal
221:longitudinal ligaments
2823:Personalized medicine
2682:Reproductive medicine
2607:Occupational medicine
2561:Evolutionary medicine
2094:Facet joint arthrosis
1908:Scheuermann's disease
746:mesenchymal stem cell
515:
261:within the vertebra (
2843:Traditional medicine
2803:Alternative medicine
2670:Addiction psychiatry
2484:Transfusion medicine
2479:Medical microbiology
2394:Gynecologic oncology
2246:Reproductive surgery
1719:www.animalplanet.com
1621:Global Spine Journal
852:Izzo, R (May 2015).
779:Failed back syndrome
709:Spinal decompression
639:intervertebral discs
255:lumbar hyperlordosis
201:intervertebral discs
2865:History of medicine
2848:Veterinary medicine
2655:Preventive medicine
2507:Adolescent medicine
2349:Infectious diseases
1411:Asian Spine Journal
1325:. 7 September 2023.
1238:2017PLoSO..1274518C
1000:Asian Spine Journal
815:(24): E1448–E1465.
557:Cutibacterium acnes
2813:Molecular oncology
2770:Doctor of Medicine
2760:Master of Medicine
2677:Radiation oncology
2549:Emergency medicine
2502:Addiction medicine
2469:Clinical chemistry
2464:Clinical pathology
2256:Transplant surgery
2214:Orthopedic surgery
2192:Colorectal surgery
1584:ClinicalTrials.gov
622:Anterior cervical
613:minimally invasive
529:
471:vitamin D receptor
344:Signs and symptoms
2931:
2930:
2765:Master of Surgery
2729:
2728:
2714:Tropical medicine
2660:Prison healthcare
2575:Hospital medicine
2539:Disaster medicine
2529:Aviation medicine
2344:Hospital medicine
2251:Surgical oncology
2236:Pediatric surgery
2230:
2177:Endocrine surgery
2102:
2101:
2020:
2019:
1995:Spondylolisthesis
1921:
1920:
1825:
1824:
924:Pembroke Observer
678:vertebral foramen
559:may play a role.
318:strength training
298:disc degeneration
271:vertebral foramen
231:malalignment and
190:
189:
126:Medical condition
124:
123:
100:
2956:
2921:
2920:
2911:
2901:
2900:
2891:
2890:
2881:
2880:
2585:Medical genetics
2570:General practice
2447:Nuclear medicine
2322:Gastroenterology
2278:Vascular surgery
2228:
2155:
2154:
2129:
2122:
2115:
2106:
2105:
1978:non inflammatory
1964:Spondylodiscitis
1932:
1931:
1874:Spinal curvature
1870:
1869:
1852:
1845:
1838:
1829:
1828:
1741:
1740:
1729:
1728:
1726:
1725:
1711:
1705:
1704:
1694:
1677:(4): E208–E215.
1661:
1655:
1654:
1644:
1612:
1606:
1605:
1594:
1588:
1587:
1576:
1570:
1569:
1567:
1566:
1551:
1545:
1544:
1534:
1524:
1500:
1494:
1493:
1475:
1466:(4): 1011–1025.
1451:
1445:
1444:
1434:
1402:
1396:
1395:
1393:
1392:
1382:
1376:
1375:
1365:
1333:
1327:
1326:
1319:
1313:
1312:
1276:
1270:
1269:
1259:
1249:
1216:
1210:
1209:
1199:
1182:(5): 1122–1129.
1167:
1161:
1160:
1150:
1118:
1112:
1108:
1102:
1101:
1064:
1058:
1057:
1055:
1054:
1040:
1034:
1033:
1023:
991:
985:
984:
982:
981:
966:
960:
959:
957:
956:
942:
936:
935:
919:
913:
912:
910:
909:
895:
889:
888:
886:
884:
849:
843:
842:
824:
800:
581:physical therapy
467:type IX collagen
415:annulus fibrosus
411:nucleus pulposus
398:nucleus pulposus
314:physical therapy
290:neuropathic pain
225:vertebral bodies
213:oncotic pressure
149:
129:
128:
119:
118:
110:
107:
101:
99:
58:
27:
26:
19:
2964:
2963:
2959:
2958:
2957:
2955:
2954:
2953:
2934:
2933:
2932:
2927:
2869:
2858:Chief physician
2791:
2736:
2725:
2719:Travel medicine
2704:Sports medicine
2687:Sexual medicine
2627:Palliative care
2622:Pain management
2566:Family medicine
2544:Diving medicine
2490:
2418:
2380:
2373:
2289:
2282:
2241:Plastic surgery
2187:General surgery
2167:Cardiac surgery
2148:
2146:
2138:
2133:
2103:
2098:
2079:Schmorl's nodes
2065:
2039:Upper back pain
2016:
2007:Spinal stenosis
1973:
1917:
1896:
1861:
1856:
1826:
1821:
1820:
1752:
1738:
1733:
1732:
1723:
1721:
1713:
1712:
1708:
1662:
1658:
1613:
1609:
1596:
1595:
1591:
1586:. 2 March 2020.
1578:
1577:
1573:
1564:
1562:
1553:
1552:
1548:
1501:
1497:
1452:
1448:
1403:
1399:
1390:
1388:
1384:
1383:
1379:
1334:
1330:
1321:
1320:
1316:
1277:
1273:
1232:(4): e0174518.
1217:
1213:
1168:
1164:
1119:
1115:
1109:
1105:
1065:
1061:
1052:
1050:
1042:
1041:
1037:
992:
988:
979:
977:
967:
963:
954:
952:
944:
943:
939:
920:
916:
907:
905:
897:
896:
892:
882:
880:
850:
846:
801:
797:
792:
775:
759:
741:Adult stem cell
729:
724:spinal stenosis
609:Microdiscectomy
573:
565:
553:spinal stenosis
510:
463:type I collagen
445:spinal stenosis
407:
390:anulus fibrosus
346:
326:massage therapy
263:spinal stenosis
217:anulus fibrosus
127:
120:
116:
111:
105:
102:
59:
48:
44:primary sources
28:
24:
17:
12:
11:
5:
2962:
2952:
2951:
2946:
2929:
2928:
2926:
2925:
2915:
2905:
2895:
2885:
2874:
2871:
2870:
2868:
2867:
2862:
2861:
2860:
2850:
2845:
2840:
2835:
2830:
2825:
2820:
2815:
2810:
2805:
2799:
2797:
2796:Related topics
2793:
2792:
2790:
2789:
2788:
2787:
2777:
2772:
2767:
2762:
2757:
2752:
2747:
2745:Medical school
2741:
2739:
2731:
2730:
2727:
2726:
2724:
2723:
2722:
2721:
2711:
2706:
2701:
2699:Sleep medicine
2696:
2695:
2694:
2684:
2679:
2674:
2673:
2672:
2662:
2657:
2652:
2646:
2641:
2640:
2639:
2629:
2624:
2619:
2614:
2609:
2604:
2603:
2602:
2592:
2587:
2582:
2577:
2572:
2563:
2558:
2557:
2556:
2546:
2541:
2536:
2531:
2526:
2525:
2524:
2519:
2512:Anesthesiology
2509:
2504:
2498:
2496:
2492:
2491:
2489:
2488:
2487:
2486:
2481:
2476:
2471:
2466:
2461:
2451:
2450:
2449:
2444:
2442:Neuroradiology
2439:
2428:
2426:
2420:
2419:
2417:
2416:
2411:
2406:
2401:
2396:
2391:
2385:
2383:
2379:Obstetrics and
2375:
2374:
2372:
2371:
2366:
2361:
2356:
2351:
2346:
2341:
2336:
2331:
2330:
2329:
2319:
2314:
2309:
2304:
2294:
2292:
2284:
2283:
2281:
2280:
2275:
2274:
2273:
2263:
2261:Trauma surgery
2258:
2253:
2248:
2243:
2238:
2233:
2232:
2231:
2224:Otolaryngology
2221:
2216:
2211:
2206:
2201:
2200:
2199:
2194:
2184:
2179:
2174:
2169:
2163:
2161:
2152:
2150:subspecialties
2140:
2139:
2132:
2131:
2124:
2117:
2109:
2100:
2099:
2097:
2096:
2091:
2086:
2081:
2075:
2073:
2067:
2066:
2064:
2063:
2058:
2057:
2056:
2051:
2041:
2036:
2030:
2028:
2022:
2021:
2018:
2017:
2015:
2014:
2012:Facet syndrome
2009:
2004:
2003:
2002:
2000:Retrolisthesis
1992:
1987:
1981:
1979:
1975:
1974:
1972:
1971:
1969:Pott's disease
1966:
1961:
1956:
1951:
1950:
1949:
1938:
1936:
1929:
1923:
1922:
1919:
1918:
1916:
1915:
1910:
1904:
1902:
1898:
1897:
1895:
1894:
1889:
1884:
1878:
1876:
1867:
1863:
1862:
1859:Spinal disease
1855:
1854:
1847:
1840:
1832:
1823:
1822:
1819:
1818:
1807:
1796:
1769:
1753:
1748:
1747:
1745:
1744:Classification
1737:
1736:External links
1734:
1731:
1730:
1706:
1656:
1627:(5): 497–518.
1607:
1589:
1571:
1546:
1495:
1446:
1417:(2): 211–215.
1397:
1377:
1348:(7): 540–546.
1328:
1314:
1271:
1211:
1162:
1113:
1111:2015;49:589-94
1103:
1076:(6): 700–704.
1059:
1035:
986:
961:
937:
914:
890:
864:(5): 746–756.
844:
794:
793:
791:
788:
787:
786:
784:Herniated disk
781:
774:
771:
758:
755:
728:
727:
716:
706:
703:
693:
687:
681:
671:
661:
657:
646:
628:
620:
605:
572:
569:
564:
561:
533:fibrocartilage
521:fibrocartilage
509:
506:
426:herniated disc
406:
403:
345:
342:
309:intervention.
188:
187:
182:
176:
175:
170:
164:
163:
160:vertebral body
151:
150:
142:
141:
138:
134:
133:
125:
122:
121:
114:
112:
31:
29:
22:
15:
9:
6:
4:
3:
2:
2961:
2950:
2947:
2945:
2942:
2941:
2939:
2924:
2916:
2914:
2910:
2906:
2904:
2896:
2894:
2886:
2884:
2876:
2875:
2872:
2866:
2863:
2859:
2856:
2855:
2854:
2851:
2849:
2846:
2844:
2841:
2839:
2836:
2834:
2831:
2829:
2828:Public health
2826:
2824:
2821:
2819:
2816:
2814:
2811:
2809:
2808:Allied health
2806:
2804:
2801:
2800:
2798:
2794:
2786:
2783:
2782:
2781:
2778:
2776:
2773:
2771:
2768:
2766:
2763:
2761:
2758:
2756:
2753:
2751:
2748:
2746:
2743:
2742:
2740:
2738:
2732:
2720:
2717:
2716:
2715:
2712:
2710:
2707:
2705:
2702:
2700:
2697:
2693:
2690:
2689:
2688:
2685:
2683:
2680:
2678:
2675:
2671:
2668:
2667:
2666:
2663:
2661:
2658:
2656:
2653:
2650:
2647:
2645:
2642:
2638:
2635:
2634:
2633:
2630:
2628:
2625:
2623:
2620:
2618:
2617:Oral medicine
2615:
2613:
2612:Ophthalmology
2610:
2608:
2605:
2601:
2598:
2597:
2596:
2593:
2591:
2588:
2586:
2583:
2581:
2578:
2576:
2573:
2571:
2567:
2564:
2562:
2559:
2555:
2552:
2551:
2550:
2547:
2545:
2542:
2540:
2537:
2535:
2532:
2530:
2527:
2523:
2520:
2518:
2515:
2514:
2513:
2510:
2508:
2505:
2503:
2500:
2499:
2497:
2493:
2485:
2482:
2480:
2477:
2475:
2474:Cytopathology
2472:
2470:
2467:
2465:
2462:
2460:
2457:
2456:
2455:
2452:
2448:
2445:
2443:
2440:
2438:
2435:
2434:
2433:
2430:
2429:
2427:
2425:
2421:
2415:
2414:Urogynecology
2412:
2410:
2407:
2405:
2402:
2400:
2397:
2395:
2392:
2390:
2387:
2386:
2384:
2382:
2376:
2370:
2367:
2365:
2362:
2360:
2357:
2355:
2352:
2350:
2347:
2345:
2342:
2340:
2337:
2335:
2332:
2328:
2325:
2324:
2323:
2320:
2318:
2317:Endocrinology
2315:
2313:
2310:
2308:
2305:
2303:
2299:
2296:
2295:
2293:
2291:
2285:
2279:
2276:
2272:
2269:
2268:
2267:
2264:
2262:
2259:
2257:
2254:
2252:
2249:
2247:
2244:
2242:
2239:
2237:
2234:
2227:
2226:
2225:
2222:
2220:
2217:
2215:
2212:
2210:
2207:
2205:
2202:
2198:
2195:
2193:
2190:
2189:
2188:
2185:
2183:
2180:
2178:
2175:
2173:
2170:
2168:
2165:
2164:
2162:
2160:
2156:
2153:
2151:
2145:
2141:
2137:
2130:
2125:
2123:
2118:
2116:
2111:
2110:
2107:
2095:
2092:
2090:
2087:
2085:
2082:
2080:
2077:
2076:
2074:
2072:
2068:
2062:
2061:Radiculopathy
2059:
2055:
2052:
2050:
2047:
2046:
2045:
2044:Low back pain
2042:
2040:
2037:
2035:
2032:
2031:
2029:
2027:
2023:
2013:
2010:
2008:
2005:
2001:
1998:
1997:
1996:
1993:
1991:
1990:Spondylolysis
1988:
1986:
1983:
1982:
1980:
1976:
1970:
1967:
1965:
1962:
1960:
1957:
1955:
1952:
1948:
1945:
1944:
1943:
1940:
1939:
1937:
1933:
1930:
1928:
1927:Spondylopathy
1924:
1914:
1911:
1909:
1906:
1905:
1903:
1899:
1893:
1890:
1888:
1885:
1883:
1880:
1879:
1877:
1875:
1871:
1868:
1864:
1860:
1853:
1848:
1846:
1841:
1839:
1834:
1833:
1830:
1817:
1813:
1812:
1808:
1806:
1802:
1801:
1797:
1795:
1791:
1787:
1783:
1779:
1778:
1774:
1770:
1768:
1764:
1763:
1759:
1755:
1754:
1751:
1746:
1742:
1720:
1716:
1710:
1702:
1698:
1693:
1688:
1684:
1680:
1676:
1672:
1668:
1660:
1652:
1648:
1643:
1638:
1634:
1630:
1626:
1622:
1618:
1611:
1603:
1599:
1593:
1585:
1581:
1580:"NCT03347708"
1575:
1561:on 2009-01-08
1560:
1556:
1550:
1542:
1538:
1533:
1528:
1523:
1518:
1514:
1510:
1506:
1499:
1491:
1487:
1483:
1479:
1474:
1469:
1465:
1461:
1457:
1450:
1442:
1438:
1433:
1428:
1424:
1420:
1416:
1412:
1408:
1401:
1387:
1381:
1373:
1369:
1364:
1359:
1355:
1351:
1347:
1343:
1339:
1332:
1324:
1318:
1310:
1306:
1302:
1298:
1294:
1290:
1286:
1282:
1275:
1267:
1263:
1258:
1253:
1248:
1243:
1239:
1235:
1231:
1227:
1223:
1215:
1207:
1203:
1198:
1193:
1189:
1185:
1181:
1177:
1173:
1166:
1158:
1154:
1149:
1144:
1140:
1136:
1133:(2): 98–112.
1132:
1128:
1124:
1117:
1107:
1099:
1095:
1091:
1087:
1083:
1079:
1075:
1071:
1063:
1049:
1045:
1039:
1031:
1027:
1022:
1017:
1013:
1009:
1006:(4): 801–19.
1005:
1001:
997:
990:
976:
972:
965:
951:
947:
941:
933:
929:
926:. p. 7.
925:
918:
904:
900:
894:
879:
875:
871:
867:
863:
859:
855:
854:"Spinal Pain"
848:
840:
836:
832:
828:
823:
818:
814:
810:
806:
799:
795:
785:
782:
780:
777:
776:
770:
768:
764:
757:Other animals
754:
750:
747:
742:
738:
733:
725:
721:
717:
714:
710:
707:
704:
701:
697:
694:
691:
688:
685:
682:
679:
675:
672:
669:
665:
662:
658:
655:
651:
647:
644:
643:spinal column
640:
636:
632:
629:
625:
621:
618:
614:
610:
607:
606:
604:
602:
601:spinal fusion
596:
594:
590:
586:
582:
578:
568:
560:
558:
554:
550:
549:spondylolysis
544:
542:
538:
534:
526:
522:
518:
514:
505:
503:
499:
495:
494:polymorphisms
492:
491:interleukin-6
488:
487:interleukin-1
484:
480:
476:
472:
468:
464:
459:
457:
453:
448:
446:
441:
436:
434:
429:
427:
423:
422:spinal column
418:
416:
412:
402:
399:
395:
391:
386:
382:
380:
376:
372:
368:
364:
360:
356:
350:
341:
339:
335:
331:
327:
323:
319:
315:
310:
308:
304:
299:
295:
291:
287:
282:
280:
279:radiculopathy
276:
272:
268:
264:
260:
256:
252:
251:hyperkyphosis
249:
245:
244:hyperlordosis
242:
238:
234:
230:
226:
222:
218:
214:
210:
206:
202:
198:
194:
186:
183:
181:
177:
174:
171:
169:
165:
161:
157:
152:
148:
143:
139:
135:
130:
113:
109:
106:February 2022
98:
95:
91:
88:
84:
81:
77:
74:
70:
67: –
66:
62:
61:Find sources:
56:
52:
46:
45:
41:
37:
32:This article
30:
21:
20:
2833:Rural health
2818:Nanomedicine
2369:Rheumatology
2300: /
2219:Hand surgery
2204:Neurosurgery
2083:
1954:Sacroiliitis
1935:inflammatory
1809:
1798:
1771:
1756:
1722:. Retrieved
1718:
1709:
1674:
1670:
1659:
1624:
1620:
1610:
1602:PR News Wire
1601:
1592:
1583:
1574:
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2637:Neonatology
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2389:Gynaecology
2381:gynaecology
2364:Pulmonology
2182:Eye surgery
2144:Specialties
1985:Spondylosis
1942:Spondylitis
1913:Torticollis
1070:Climacteric
1048:Mayo Clinic
737:Glucosamine
720:laminectomy
664:Facetectomy
394:innervation
229:facet joint
173:Orthopedics
156:osteophytes
137:Other names
34:needs more
2938:Categories
2665:Psychiatry
2651:(PM&R)
2644:Phlebology
2632:Pediatrics
2459:Anatomical
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2339:Hematology
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2327:Hepatology
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2302:Immunology
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1565:2009-02-16
1391:2007-06-26
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980:2019-12-31
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908:2017-01-05
790:References
696:Laminotomy
654:bone graft
650:corpectomy
624:discectomy
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537:Histologic
517:Micrograph
508:Mechanisms
440:bone spurs
303:osteophyte
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767:Chiweenie
763:Dachshund
648:Cervical
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563:Diagnosis
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