Symptoms of mild degenerative changes in the lumbar spine

There are mild degenerative changes in the lumbar spine, and the causes are different. The most common ones are the degeneration of the lumbar disc annulus fibrosus and the degeneration of the intervertebral disc nucleus pulposus. The incidence of this disease increases, especially with age.

1. Degeneration of the lumbar disc annulus

The intervertebral disc tissue bears the weight of the human trunk and upper limbs, and is more susceptible to strain than other tissues in daily life and labor. The lumbar intervertebral disc has a small blood supply and extremely limited nutrition, making it very prone to degeneration. Studies have shown that the intervertebral discs have already started to degenerate when people are approaching their 20s, and some have already undergone obvious degeneration between the ages of 20 and 30, with cracks forming in the annulus fibrosus. The intervertebral discs of people over 30 years old all have degeneration. As age increases, the annulus fibrosus of the intervertebral disc undergoes reticular degeneration and hyaline degeneration, loses its original layers and toughness, develops various cracks, and then completely ruptures.

2. Degeneration of the nucleus pulposus of the intervertebral disc

The nucleus pulposus of the intervertebral disc is a tissue rich in water and small molecular elastic mucoglycoprotein. It contains chondrocytes and fibroblasts. The water content can reach more than 80% in childhood, which decreases with age and can reach 70% in old age. The amount of water content in the intervertebral disc determines its intrinsic pressure level and elastic state. Degeneration of the nucleus pulposus often occurs on the basis of degeneration of bone joints and annulus fibrosus. When the load on the lumbar spine increases, the intervertebral space pressure increases and the degeneration of the intervertebral disc accelerates, the cracks in the annulus fibrosus deepen, and the degenerated nucleus pulposus protrudes to the edge along the cracks, which causes lumbar disc herniation.

3. Degeneration of cartilage endplate

The cartilage endplates of the intervertebral disc become thinner, calcified, and incomplete with age, and produce cystic changes and chondrocyte necrosis. The attachment points of the annulus fibrosus loosen, accompanied by a decrease in the water content of the nucleus pulposus, and the cartilage endplates cannot be regenerated and repaired. Degeneration of the cartilage endplate will reduce the function of the translucent membrane in the exchange of intervertebral disc fluid and accelerate the degeneration of the lumbar disc.

4. Degeneration of lumbar vertebrae

After the surface of the lumbar vertebra is damaged, hematomas form above and below the periosteum, fibroblasts become active, and gradually grow into the hematoma, replacing the hematoma with granulation tissue. As the hematoma becomes organized and calcified, osteophytes (bone spurs) are eventually formed, protruding into the spinal canal or out of the vertebral body. The formation of osteophytes is a protective measure of the body, which can stabilize the vertebrae, avoid abnormal activities and increase the weight-bearing plane. However, the development of osteophytes in the spinal canal and pedicles will compress the spinal nerves and dura mater sac and cause different nerve root compression symptoms.

5. Degeneration of lumbar facet joints

The intervertebral disc and facet joints form a triangular support structure between the vertebrae to stabilize the relationship between the vertebrae. When the lumbar spine degenerates or the intervertebral joints are damaged, the stability of the facet joints is destroyed and pathological changes occur. The lumbar joint stability decreases, the joint space and intervertebral foramen narrow, and the nerve roots are compressed, resulting in symptoms.