MECHANISMS OF PROTRUSION DEVELOPMENT IN THE LUMBAR SPINE: A COMPREHENSIVE PATHOPHYSIOLOGICAL PERSPECTIVE
Keywords:
Lumbar spine, disc protrusion, pathogenesis, biomechanics, degeneration, annulus fibrosus, nucleus pulposus, inflammation, risk factors, spinal instability, low back pain, intervertebral disc.Abstract
Lumbar intervertebral disc protrusion is a common degenerative spinal disorder that significantly contributes to low back pain and functional disability worldwide. The condition arises from complex interactions between mechanical loading, age-related degeneration, biochemical alterations, and microstructural damage within the intervertebral disc. Progressive dehydration of the nucleus pulposus, disruption of annulus fibrosus integrity, and reduced disc elasticity collectively lead to loss of disc height and outward displacement of disc material. These pathological changes compromise spinal biomechanics, increase segmental instability, and predispose neural structures to compression. Recent theoretical and clinical evidence suggests that genetic predisposition, occupational stress, prolonged static postures, obesity, and inadequate muscular support further accelerate degenerative processes. Inflammatory mediators released from degenerated discs play a crucial role in pain generation and nerve sensitization, even in the absence of significant mechanical compression. Understanding the multifactorial mechanisms underlying lumbar disc protrusion is essential for developing targeted preventive strategies and optimizing conservative and interventional treatment approaches. This abstract presents a concise synthesis of current theoretical concepts regarding the pathogenesis of lumbar disc protrusion, emphasizing the interplay between biomechanical stress, cellular degeneration, and inflammatory pathways. A clearer comprehension of these mechanisms may improve early diagnosis, risk stratification, and individualized therapeutic planning.
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