From the Guidelines
Intervertebral disc prolapse is primarily caused by degenerative changes, disc herniations, and malalignment, often exacerbated by factors such as age, trauma, and spinal degenerative changes.
Causes of Intervertebral Disc Prolapse
- Degenerative changes: Degenerative spine findings, including disc protrusion, are common in asymptomatic patients and increase with age 1.
- Disc herniations: Disc herniations can cause extrinsic compression of the spinal cord, leading to myelopathy, and are a common cause of radiculopathy 2.
- Malalignment: Spinal malalignment, such as spondylolisthesis, can contribute to disc prolapse and nerve root compression 3.
- Trauma: Trauma, including minor trauma or no obvious history of trauma, can lead to vertebral fracture and retropulsion, causing myelopathy 2.
- Age: The prevalence of degenerative spine findings, including disc protrusion, increases with age, with disc protrusion prevalence increasing from 29% in those 20 years of age to 43% in those 80 years of age 1.
Risk Factors
- Family history: A family history of degenerative disc disease may increase the risk of developing disc prolapse.
- Obesity: Obesity can increase the stress on the spine, contributing to degenerative changes and disc prolapse.
- Smoking: Smoking can reduce blood flow to the discs, leading to degenerative changes and increasing the risk of disc prolapse. It is essential to note that while these factors can contribute to intervertebral disc prolapse, the majority of cases are due to degenerative changes, and many cases of disc prolapse are asymptomatic 1.
From the Research
Causes of Intervertebral Disc Prolapse
The causes of intervertebral disc prolapse can be attributed to various factors, including:
- Mechanical factors, such as mechanical, traumatic, genetic, and nutritional factors, which can affect the integrity of the intervertebral disc 4
- Degenerative processes, which involve the structural damage of the intervertebral disc and changes in the number and composition of cells 4
- Loss of proteoglycans, which is considered the main factor in the degeneration of the intervertebral disc 4
- Mechanical loading conditions, such as compression, flexion, axial rotation, and complex loading mechanisms, which can cause structural failures in intervertebral discs 5
- Chronic loading, which can have a more damaging impact on the spine than single impact or cyclical loading 5
Biomechanical Consequences
The biomechanical consequences of intervertebral disc prolapse can include:
- Imbalance of metabolic enzymes and growth factors 5
- Alteration in stress profiles of intervertebral discs 5
- Decrease in mechanical stiffness, resulting in impaired biomechanics of the spine 5
- Damage to adjacent structures, leading to functional changes, higher susceptibility to injuries, and clinical signs and symptoms 4
Clinical Manifestations
The clinical manifestations of intervertebral disc prolapse can vary, but may include: