椎间盘退变的机制及其治疗综述

The Mechanism and Treatment of Intervertebral Disc Degeneration

摘要: 椎间盘退变(intervertebral disc degeneration, IVDD)是一个多因素的过程，其表现为表型和基因型的变化，导致椎管狭窄、脊柱不稳、腰腿痛等疾病。合成代谢与分解代谢的长期失衡导致椎间盘蛋白多糖和水合作用的逐渐丧失进而改变其组成，最终导致IVDD。目前对IVDD的处理只能缓解症状，无法从根本上解决椎间盘退变的情况。研究人员正在尝试确定造成椎间盘退变的各种因素以及再生策略。近期生物学方法在IVDD领域获得了推动力。本综述讲述了目前对椎间盘退变的理解，旨在提出促进椎间盘再生策略以及不同生物疗法的最新进展，如生长因子、细胞和基因疗法，这些疗法的潜力及结果也被广泛讨论。最初，椎间盘退变的治疗包括传统的保守治疗和手术治疗，通过人们不断地努力，将来生长因子、细胞和基因疗法可能被证明是非常有效的治疗IVDD的方法。

Abstract: Intervertebral disc degeneration is a multifactorial process, which manifests as changes in phenotype and genotype, leading to spinal stenosis, spinal instability, low back pain and other diseases. The long-term imbalance between anabolism and catabolism leads to the gradual loss of intervertebral disc proteoglycan and hydration, which changes its composition and ultimately leads to IVDD. The current treatment of IVDD can only relieve symptoms, and cannot fundamentally solve the situation of intervertebral disc degeneration. Researchers are trying to determine the various factors that cause intervertebral disc degeneration and regeneration strategies. Recent biological methods have gained momentum in the field of IVDD. This review describes the current understanding of intervertebral disc degeneration, and aims to propose strategies to promote intervertebral disc regeneration and the latest advances in different biological therapies, such as growth factors, cell and gene therapies. The potential and results of these therapies have also been widely discussed. Initially, the treatment of intervertebral disc degeneration included traditional conservative treatment and surgical treatment. Through continuous efforts, growth factor, cell and gene therapy may prove to be very effective treatments for IVDD in the future.