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Related Concept Videos

Herniated Intervertebral Disc l: Introduction01:29

Herniated Intervertebral Disc l: Introduction

Intervertebral disc herniation refers to the displacement of the nucleus pulposus (the gel-like inner core of the disc) through a tear or weakened area in the annulus fibrosus (the outer fibrous ring). The displaced disc material extends beyond the normal boundaries of the disc space and may compress or irritate nearby spinal nerve roots or, less commonly, the spinal cord.Etiology and Risk FactorsHerniation commonly results from degeneration, in which aging reduces disc hydration and...
Degenerative Disc Disease ll: Pathophysiology01:23

Degenerative Disc Disease ll: Pathophysiology

The symptoms of degenerative disc disease arise from a combination of mechanical compression, vascular compromise, and biochemical inflammation, which together disrupt nerve function and produce pain.Mechanical CompressionDisc degeneration reduces height and elasticity, predisposing to herniation of the nucleus pulposus, a major cause of radicular pain. Herniations may be protrusion (bulging with intact annulus), extrusion (nucleus extends beyond disc but remains connected), or sequestration...
Degenerative Disc Disease I: Introduction01:27

Degenerative Disc Disease I: Introduction

Degenerative disc disease is a chronic condition in which intervertebral discs gradually lose structure and function. It is not infectious or autoimmune; rather, it results from age-related biochemical and mechanical changes, influenced by genetic, metabolic, and environmental factors.Structure and Function of DiscsThe spine contains 23 intervertebral discs that absorb load, distribute forces, maintain spacing, and allow flexibility. Each disc consists of a nucleus pulposus, a gel-like core...

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Related Experiment Video

Updated: May 8, 2026

A Proinflammatory, Degenerative Organ Culture Model to Simulate Early-Stage Intervertebral Disc Disease.
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Autoimmunity in intervertebral disc herniation: from bench to bedside.

Alberto Di Martino1, Luciano Merlini, Cesare Faldini

  • 1University Campus Bio-Medico of Rome, CIR - Center for Integrated Research, Department of Orthopaedics and Trauma Surgery , Rome , Italy dimartino.cbm@gmail.com.

Expert Opinion on Therapeutic Targets
|September 3, 2013
PubMed
Summary

Tumor necrosis factor-alpha (TNF-α) inhibitors show controversial short-term effects for sciatica due to disc herniation. Further research is needed to confirm long-term efficacy, safety, and cost-effectiveness of this biological therapy.

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Area of Science:

  • Neuroscience
  • Immunology
  • Orthopedics

Background:

  • Recent research re-evaluates low back pain and sciatica pathophysiology, focusing on inflammatory mediators.
  • Cytokines, particularly tumor necrosis factor-alpha (TNF-α), are implicated in sciatica from disc herniation.
  • Clinical trials have investigated TNF-α inhibitors for radicular pain secondary to herniated discs.

Purpose of the Study:

  • To review the autoimmune theory of disc herniation and its link to radiculopathy and neuropathic pain.
  • To present evidence supporting the use of anti-TNF-α drugs as biological therapy for radiculopathy and disc herniation.

Main Methods:

  • Literature review focusing on the autoimmune basis of disc herniation.
  • Analysis of evidence for anti-TNF-α therapies in radiculopathy and neuropathic pain.
  • Evaluation of clinical trial data on TNF-α inhibitors for herniated disc-related pain.

Main Results:

  • Targeting the TNF-α pathway yielded controversial results in the studied population.
  • Current available data primarily offers short-term follow-up results.
  • The role of TNF-α inhibitors in managing disc herniation and associated neuropathy remains uncertain.

Conclusions:

  • Further studies are required to establish the long-term clinical outcomes of anti-TNF-α therapy.
  • Investigation into potential complications, optimal administration routes, and cost-effectiveness is necessary.
  • The definitive role of biological therapy targeting TNF-α in disc herniation requires more robust evidence.