Osteoarthritis and intervertebral disc degeneration: Quite different, quite similar. Issue 4 (19th October 2018)

• Record Type: Journal Article
• Authors: Rustenburg, Christine M.E.; Emanuel, Kaj S.; Peeters, Mirte; Lems, Willem F.; Vergroesen, Pieter‐Paul A.; Smit, Theodoor H.
• Is Part Of: JOR spine. Volume 1:Issue 4(2018)
• Page Start: n/a
• Page End: n/a
• Publication Date: 2018-10-19
• Subjects: articular joint -- degeneration -- inflammation -- intervertebral disc -- mechanical loading -- osteoarthritis; Spine -- Diseases -- Periodicals; Spine -- Diseases -- Treatment -- Periodicals; Spine -- Wounds and injuries -- Periodicals; Orthopedics -- Periodicals; Electronic journal; Periodicals; 616.73005
• DOI: 10.1002/jsp2.1033
• Languages: English
• ISSNs: 2572-1143

Abstract

Abstract : Intervertebral disc degeneration describes the vicious cycle of the deterioration of intervertebral discs and can eventually result in degenerative disc disease (DDD), which is accompanied by low‐back pain, the musculoskeletal disorder with the largest socioeconomic impact world‐wide. In more severe stages, intervertebral disc degeneration is accompanied by loss of joint space, subchondral sclerosis, and osteophytes, similar to osteoarthritis (OA) in the articular joint. Inspired by this resemblance, we investigated the analogy between human intervertebral discs and articular joints. Although embryonic origin and anatomy suggest substantial differences between the two types of joint, some features of cell physiology and extracellular matrix in the nucleus pulposus and articular cartilage share numerous parallels. Moreover, there are great similarities in the response to mechanical loading and the matrix‐degrading factors involved in the cascade of degeneration in both tissues. This suggests that the local environment of the cell is more important to its behavior than embryonic origin. Nevertheless, OA is widely regarded as a true disease, while intervertebral disc degeneration is often regarded as a radiological finding and DDD is undervalued as a cause of chronic low‐back pain by clinicians, patients and society. Emphasizing the similarities rather than the differences between the two diseases may create more awareness in the clinic, improve diagnostics in DDD, and provide cross‐fertilization of clinicians and scientists involved in both intervertebral disc degeneration and OA. Abstract : There are striking similarties between osteoarthritis and intervertebral disc degeneration, but at the same time, a diagnostic imbalance between the two conditions consists. Creating more awareness among clinicians may reduce this imbalance, destigmatize patients by labelling them with a well‐recognized disease, and lower the threshold for patients to visit a clinician.