Mechanobiology of intervertebral disc degeneration: From pathological mechanisms to therapeutic approaches

Intervertebral disc degeneration (IVDD) is a complex mechanobiological process driven by abnormal mechanical loading, resulting in structural failure, inflammatory activation, and cellular dysfunction. Understanding these mechanobiological interactions offers novel therapeutic targets to interrupt the degenerative cascade and improve clinical outcomes in IVDD treatment. This review summarizes the fundamental characteristics of the mechanobiological microenvironment in IVDD, detailing mechanosensitive spinal components and providing evidence for mechanobiology-based therapies. By enhancing insight into disc degeneration from a mechanobiological perspective, researchers can develop innovative therapeutic strategies to restore a healthy disc microenvironment and spinal stability clinically, offering a promising outlook for patients with IVDD. However, current studies primarily focus on in vitro models and in vivo animal studies, limiting clinical translation. Therefore, effectively translating these research findings into practical clinical treatments remains a notable future challenge.