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Normal aging in human lumbar discs: An ultrastructural comparison.

Ricardo B V Fontes1, Josemberg S Baptista2, Said R Rabbani3

  • 1Department of Neurosurgery, Rush University Medical Center, Chicago, Illinois, United States of America.

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Summary

Aging human lumbar discs show extracellular matrix changes, with decreased collagen and more cartilage-like features in older adults. These modifications occur similarly in anterior and posterior disc regions, particularly in the posterior areas.

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Area of Science:

  • Biomaterials Science
  • Orthopedic Research
  • Aging and Degenerative Diseases

Background:

  • The aging process of the extracellular matrix (ECM) and collagen in human lumbar intervertebral discs (IVDs) is not well understood.
  • Previous research often used inadequate models, hindering the study of truly normal human IVDs.
  • Understanding IVD aging is crucial for addressing age-related back pain and mobility issues.

Purpose of the Study:

  • To describe and compare the morphology and ultrastructure of lumbar IVDs in young (G1, <35 years) and elderly (G2, >65 years) individuals.
  • To investigate changes in ECM composition, particularly collagen types, during normal aging and degeneration.
  • To correlate structural and compositional changes with age and degeneration grade.

Main Methods:

  • Analyzed 30 lumbar IVDs (L4-5, L5-S1) per group from autopsies of asymptomatic individuals.
  • Utilized magnetic resonance imaging (MRI), morphological grading, light microscopy, scanning electron microscopy (SEM), and immunohistochemistry (IHC).
  • Examined collagen types I, II, III, IV, V, VI, IX, and X using IHC.

Main Results:

  • Elderly discs (G2) showed significantly more advanced degeneration than younger discs (G1).
  • G2 discs had a more compact ECM with increased cartilaginous features and chondrocyte clusters; elastic fibers were rare in G2.
  • Collagen expression generally decreased from G1 to G2, with specific patterns in annular and nuclear regions, suggesting earlier changes in posterior disc areas.

Conclusions:

  • Lumbar IVD aging involves significant ECM modification, including collagen alterations and increased cartilaginous features, particularly in older individuals.
  • Structural changes are evident even with advanced age or degeneration, with elastic fibers decreasing significantly with age.
  • The study provides a detailed description of ECM modification during disc degeneration in a general population, highlighting similarities with cervical spine aging.