Adams and Roughley review the existing literature on intervertebral disc degeneration to propose formal working definitions that distinguish true degeneration from normal aging, healing, and adaptive remodeling — addressing the absence of any accepted consensus definition in biomedical research or medicolegal practice.
When evaluating a patient's MRI, resist labeling a "dark disc" or age-related signal change as degenerative disc disease — reserve that term for structural failure (radial fissure, endplate fracture, collapse, herniation) in a disc that is also clinically painful.
This framework also explains why biologics or cell-based therapies targeting disc cell physiology are unlikely to succeed in a structurally disrupted disc: the abnormal mechanical environment driving aberrant cell behavior must be addressed simultaneously.
Adams and Roughley review the existing literature on intervertebral disc degeneration to propose formal working definitions that distinguish true degeneration from normal aging, healing, and adaptive remodeling — addressing the absence of any accepted consensus definition in biomedical research or medicolegal practice.
When evaluating a patient's MRI, resist labeling a "dark disc" or age-related signal change as degenerative disc disease — reserve that term for structural failure (radial fissure, endplate fracture, collapse, herniation) in a disc that is also clinically painful.
This framework also explains why biologics or cell-based therapies targeting disc cell physiology are unlikely to succeed in a structurally disrupted disc: the abnormal mechanical environment driving aberrant cell behavior must be addressed simultaneously.