Could sudden increases in physical activity cause degeneration of intervertebral discs?

被引:37
作者
Adams, MA
Dolan, P
机构
关键词
D O I
10.1016/S0140-6736(97)03021-3
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Epidemiological studies link high repetitive loading of the lower back with degeneration of intervertebral discs, and experiments on cadaver spines confirm that repetitive mechanical loading can disrupt the lumbar discs in a manner characteristic of ''degeneration''. But why do living discs not just strengthen in response to this stimulus, as other musculo-skeletal tissues do? Our hypothesis proposes that the low metabolic rate of lumbar discs (the largest avascular structures in the body) prevents them from keeping pace with adaptive remodelling changes in adjacent tissues, so that large and abrupt increases in a person's level of physical activity may leave the lumbar discs the weak link in a strengthening and heavily loaded spine. Recent laboratory investigations support the hypothesis, but clinical evidence Is required to relate recent disc degeneration with recent increases in physical activity, and so test the hypothesis.
引用
收藏
页码:734 / 735
页数:2
相关论文
共 23 条
[1]   PROLAPSED INTERVERTEBRAL-DISK - A HYPERFLEXION INJURY [J].
ADAMS, MA ;
HUTTON, WC .
SPINE, 1982, 7 (03) :184-191
[2]   GRADUAL DISK PROLAPSE [J].
ADAMS, MA ;
HUTTON, WC .
SPINE, 1985, 10 (06) :524-531
[3]   POSTURE AND THE COMPRESSIVE STRENGTH OF THE LUMBAR SPINE [J].
ADAMS, MA ;
MCNALLY, DS ;
CHINN, H ;
DOLAN, P .
CLINICAL BIOMECHANICS, 1994, 9 (01) :5-14
[4]  
ADAMS MA, 1995, INT SOC STUD LUMB SP
[5]   Determinants of lumbar disc degeneration - A study relating lifetime exposures and magnetic resonance imaging findings in identical twins [J].
Battie, MC ;
Videman, T ;
Gibbons, LE ;
Fisher, LD ;
Manninen, H ;
Gill, K .
SPINE, 1995, 20 (24) :2601-2612
[6]   PROTEOGLYCAN SYNTHESIS IN THE HUMAN INTERVERTEBRAL-DISK - VARIATION WITH AGE, REGION AND PATHOLOGY [J].
BAYLISS, MT ;
JOHNSTONE, B ;
OBRIEN, JP .
SPINE, 1988, 13 (09) :972-981
[7]   The diagnostic accuracy of magnetic resonance imaging, work perception, and psychosocial factors in identifying symptomatic disc herniations [J].
Boos, N ;
Rieder, R ;
Schade, V ;
Spratt, KF ;
Semmer, N ;
Aebi, M .
SPINE, 1995, 20 (24) :2613-2625
[8]   BENDING AND COMPRESSIVE STRESSES ACTING ON THE LUMBAR SPINE DURING LIFTING ACTIVITIES [J].
DOLAN, P ;
EARLEY, M ;
ADAMS, MA .
JOURNAL OF BIOMECHANICS, 1994, 27 (10) :1237-+
[9]   THE LOADS ON THE LUMBAR SPINE DURING EXTREME WEIGHT LIFTING [J].
GRANHED, H ;
JONSON, R ;
HANSSON, T .
SPINE, 1987, 12 (02) :146-149
[10]  
Green T P, 1993, Eur Spine J, V2, P209, DOI 10.1007/BF00299448